Biomarkers and methods of treating PD-1 and PD-L1 related conditions

ABSTRACT

Provided herein are biomarkers for the treatment of pathological conditions, such as cancer, and method of using PD-1/PD-L1 pathway antagonists. In particular, provided are biomarkers for patient selection and prognosis in cancer, as well as methods of therapeutic treatment, articles of manufacture and methods for making them, diagnostic kits, methods of detection and methods of advertising related thereto.

CROSS REFERENCE TO RELATED APPLICATIONS

This application is a continuation of International Application No.PCT/US 2014/024746, filed 12 Mar. 2014, which claims the benefit ofpriority of provisional U.S. Application Nos. 61/802,296, filed 15 Mar.2013; 61/812,678, filed 16 Apr. 2013; 61/829,236, filed 30 May 2013; and61/883,186, filed 26 Sep. 2013, which are hereby incorporated byreference in their entirety.

SEQUENCE LISTING

The instant application contains a Sequence Listing submitted viaEFS-Web and hereby incorporated by reference in its entirety. Said ASCIIcopy, created on Apr. 18, 2016, is namedP05574-US-5SubstituteSeqListing.txt, and is 8,955 bytes in size.

FIELD

Provided herein are biomarkers for the treatment of pathologicalconditions, such as cancer, and methods of using PD-L1/PD-1 pathwayantagonists. In particular, provided biomarkers for patient selectionand prognosis in cancer, as well as methods of therapeutic treatment,articles of manufacture and methods for making them, diagnostic kits,methods of detection and methods of advertising related thereto.

BACKGROUND

Cancer remains to be one of the most deadly threats to human health. Inthe U.S., cancer affects nearly 1.3 million new patients each year, andis the second leading cause of death after heart disease, accounting forapproximately 1 in 4 deaths. For example, lung cancer is the most commonform of cancer and the leading cancer killer among American women. It isalso predicted that cancer may surpass cardiovascular diseases as thenumber one cause of death within 5 years. Solid tumors are responsiblefor most of those deaths. Although there have been significant advancesin the medical treatment of certain cancers, the overall 5-year survivalrate for all cancers has improved only by about 10% in the past 20years. Cancers, or malignant tumors, metastasize and grow rapidly in anuncontrolled manner, making timely detection and treatment extremelydifficult.

Despite the significant advancement in the treatment of cancer, improvedtherapies are still being sought.

All references cited herein, including patent applications andpublications, are incorporated by reference in their entirety.

SUMMARY

Provided herein are methods identifying an individual with a disease ordisorder who is more likely to respond to treatment with a PD-L1 axisbinding antagonist, the method comprising: determining the presence of aPD-L1 biomarker in a sample from the individual, wherein the presence ofa PD-L1 biomarker in the sample indicates that the individual is morelikely to respond to treatment with the PD-L1 axis binding antagonist,and providing a recommendation that the individual will be more likelyto respond to treatment with a PD-L1 axis binding antagonist.

Provided herein are methods for predicting responsiveness of anindividual with a disease or disorder to treatment with a PD-L1 axisbinding antagonist, the method comprising: determining the presence of aPD-L1 biomarker in a sample from the individual, wherein the presence ofa PD-L1 biomarker in the sample indicates that the individual is morelikely to be responsive to treatment with the PD-L1 axis bindingantagonist, and providing a recommendation that the individual will havean increased likelihood of being responsive to treatment with a PD-L1axis binding antagonist.

Provided herein are methods for determining likelihood that anindividual with a disease or disorder will exhibit benefit fromtreatment with a PD-L1 axis binding antagonist, the method comprising:determining the presence of a PD-L1 biomarker in a sample from theindividual, wherein the presence of a PD-L1 biomarker in the sampleindicates that the individual has an increased likelihood of benefitfrom treatment with the PD-L1 axis binding antagonist, and providing arecommendation that the individual will have an increased likelihood ofbenefit from treatment with a PD-L1 axis binding antagonist.

Provided herein are methods for selecting a therapy for an individualwith a disease or disorder, the method comprising: determining thepresence of a PD-L1 biomarker in a sample from the individual, andproviding a recommendation that the therapy selected for the individualcomprise treatment with a PD-L1 axis binding antagonist based on thepresence of a PD-L1 biomarker in the sample.

In some embodiments, the methods further comprise administering aneffective amount of the PD-L1 axis binding antagonist to the individual.

Provided herein are methods for treating a disease or disorder in anindividual, the method comprising: determining the presence of a PD-L1biomarker in a sample from the individual, and administering aneffective amount of a PD-L1 axis binding antagonist to the individual.

Provided herein are methods of treating a disease or disorder in anindividual comprising administering to the individual an effectiveamount of a PD-L1 axis binding antagonist, wherein treatment is basedupon the presence of a PD-L1 biomarker in a sample from the individual.

Provided herein are methods for advertising a PD-L1 axis bindingantagonist comprising promoting, to a target audience, the use of thePD-L1 axis binding antagonist for treating an individual with a diseaseor disorder based on the presence of a PD-L1 biomarker.

Provided herein are assays for identifying an individual with a diseaseor disorder to receive a PD-L1 axis binding antagonist, the methodcomprising: determining the presence of a PD-L1 biomarker in a samplefrom the individual, and recommending a PD-L1 axis binding antagonistbased on the presence of a PD-L1 biomarker.

Provided herein are diagnostic kits comprising one or more reagent fordetermining the presence of a PD-L1 biomarker in a sample from anindividual with a disease or disorder, wherein the presence of a PD-L1biomarker means a higher likelihood of efficacy when the individual istreated with a PD-L1 axis binding antagonist, and wherein the absence ofa PD-L1 biomarker means a less likelihood of efficacy when theindividual with the disease is treated with the PD-L1 axis bindingantagonist.

Provided herein are also articles of manufacture comprising, packagedtogether, a PD-L1 axis binding antagonist, in a pharmaceuticallyacceptable carrier and a package insert indicating that the PD-L1 axisbinding antagonist is for treating a patient with a disease or disorderbased on expression of a PD-L1 biomarker. Treatment methods include anyof the treatment methods disclosed herein. Further provided are methodsfor manufacturing an article of manufacture comprising combining in apackage a pharmaceutical composition comprising a PD-L1 axis bindingantagonist and a package insert indicating that the pharmaceuticalcomposition is for treating a patient with a disease or disorder basedon expression of a PD-L1 biomarker.

In some embodiments of any of the methods, assays and/or kits, the PD-L1biomarker is selected from the group consisting of PD-L1, PD-1, PD-L2and any combinations thereof.

In some embodiments of any of the methods, assays and/or kits, the PD-L1biomarker is an immune-related marker. In some embodiments, theimmune-related marker is a T-cell related marker. In some embodiments,the T-cell related marker is selected from the group consisting of CD8A,IFN-g, EOMES, Granzyme-A, CXCL9 and any combinations thereof. In someembodiments, the immune-related marker is selected from the groupconsisting of CX3CL1, CD45RO, IDO1, Galectin 9, MIC-A, MIC-B, CTLA-4 andany combinations thereof.

In some embodiments of any of the methods, assays and/or kits, thedisease or disorder is a proliferative disease or disorder. In someembodiments of any of the methods, assays and/or kits, the disease ordisorder is an immune-related disease or disorder. In some embodimentsof any of the methods, assays and/or kits, the disease or disorder iscancer. In some embodiments, the cancer is selected from the groupconsisting of non-small cell lung cancer, small cell lung cancer, renalcell cancer, colorectal cancer, ovarian cancer, breast cancer,pancreatic cancer, gastric carcinoma, bladder cancer, esophageal cancer,mesothelioma, melanoma, head and neck cancer, thyroid cancer, sarcoma,prostate cancer, glioblastoma, cervical cancer, thymic carcinoma,leukemia, lymphomas, myelomas, mycoses fungoids, merkel cell cancer, andother hematologic malignancies.

In some embodiments of any of the methods, assays and/or kits, whereinthe sample obtained from the individual is selected from the groupconsisting of tissue, whole blood, plasma, serum and combinationsthereof. In some embodiments, the tissue sample is a tumor tissuesample. In some embodiments, the tumor tissue sample comprises tumorcells, tumor infiltrating immune cells, stromal cells and anycombinations thereof. In some embodiments, the tissue sample is formalinfixed and paraffin embedded, archival, fresh or frozen. In someembodiments, the sample is whole blood. In some embodiments, the wholeblood comprises immune cells, circulating tumor cells and anycombinations thereof.

In some embodiments of any of the methods, assays and/or kits, thesample is obtained prior to treatment with a PD-L1 axis bindingantagonist.

In some embodiments of any of the methods, assays and/or kits, thepresence of a PD-L1 biomarker indicates that the individual is likely tohave increased clinical benefit when the individual is treated with thePD-L1 axis binding antagonist. In some embodiments, the increasedclinical benefit comprises a relative increase in one or more of thefollowing: overall survival (OS), progression free survival (PFS),complete response (CR), partial response (PR) and combinations thereof.

In some embodiments of any of the methods, assays and/or kits, the PD-L1biomarker is absent from the sample when it comprises 0% of the sample.

In some embodiments of any of the methods, assays and/or kits, the PD-L1biomarker is present in the sample when it comprises more than 0% of thesample. In some embodiments, the PD-L1 biomarker is present in at least1% of the sample. In some embodiments, the PD-L1 biomarker is present inat least 5% of the sample. In some embodiments, the PD-L1 biomarker ispresent in at least 10% of the sample.

In some embodiments of any of the methods, assays and/or kits, the PD-L1biomarker is detected in the sample using a method selected from thegroup consisting of FACS, Western blot, ELISA, immunoprecipitation,immunohistochemistry, immunofluorescence, radioimmunoassay, dotblotting, immunodetection methods, HPLC, surface plasmon resonance,optical spectroscopy, mass spectrometery, HPLC, qPCR, RT-qPCR, multiplexqPCR or RT-qPCR, RNA-seq, microarray analysis, SAGE, MassARRAYtechnique, and FISH, and combinations thereof.

In some embodiments of any of the methods, assays and/or kits, the PD-L1biomarker is detected in the sample by protein expression. In someembodiments, protein expression is determined by immunohistochemistry(IHC). In some embodiments, the PD-L1 biomarker is detected using ananti-PD-L1 antibody. In some embodiments, the PD-L1 biomarker isdetected as a weak staining intensity by IHC. In some embodiments, thePD-L1 biomarker is detected as a moderate staining intensity by IHC. Insome embodiments, the PD-L1 biomarker is detected as a strong stainingintensity by IHC. In some embodiments, the PD-L1 biomarker is detectedon tumor cells, tumor infiltrating immune cells, stromal cells and anycombinations thereof. In some embodiments, the staining is membranestaining, cytoplasmic staining or combinations thereof.

In some embodiments of any of the methods, assays and/or kits, theabsence of the PD-L1 biomarker is detected as absent or no staining inthe sample. In some embodiments of any of the methods, assays and/orkits, the presence of the PD-L1 biomarker is detected as any staining inthe sample.

In some embodiments of any of the methods, assays and/or kits, the PD-L1biomarker is detected in the sample by nucleic acid expression. In someembodiments, the nucleic acid expression is determined using qPCR,RT-qPCR, multiplex qPCR or RT-qPCR, RNA-seq, microarray analysis, SAGE,MassARRAY technique, or FISH. In some embodiments, the PD-L1 biomarkeris detected on tumor cells, tumor infiltrating immune cells, stromalcells and any combinations thereof.

In some embodiments of any of the methods, assays and/or kits, the PD-L1axis binding antagonist is selected from the group consisting of a PD-L1binding antagonist and a PD-1 binding antagonist.

In some embodiments of any of the methods, assays and/or kits, the PD-L1axis binding antagonist is a PD-L1 binding antagonist. In someembodiments of any of the methods, assays and/or kits, the PD-L1 bindingantagonist inhibits the binding of PD-L1 to its ligand binding partners.In some embodiments of any of the methods, assays and/or kits, the PD-L1binding antagonist inhibits the binding of PD-L1 to PD-1. In someembodiments of any of the methods, assays and/or kits, the PD-L1 bindingantagonist inhibits the binding of PD-L1 to B7-1. In some embodiments ofany of the methods, assays and/or kits, the PD-L1 binding antagonistinhibits the binding of PD-L1 to both PD-1 and B7-1.

In some embodiments of any of the methods, assays and/or kits, the PD-L1binding antagonist is an antibody. In some embodiments of any of themethods, assays and/or kits, the antibody is a monoclonal antibody. Insome embodiments of any of the methods, assays and/or kits, the antibodyis a human, humanized or chimeric antibody.

In some embodiments of any of the methods, assays and/or kits, the PD-L1axis binding antagonist is a PD-1 binding antagonist. In someembodiments of any of the methods, assays and/or kits, the PD-1 bindingantagonist inhibits the binding of PD-1 to its ligand binding partners.In some embodiments of any of the methods, assays and/or kits, the PD-1binding antagonist inhibits the binding of PD-1 to PD-L1. In someembodiments of any of the methods, assays and/or kits, the PD-1 bindingantagonist inhibits the binding of PD-1 to PD-L2. In some embodiments ofany of the methods, assays and/or kits, the PD-1 binding antagonistinhibits the binding of PD-1 to both PD-L1 and PD-L2.

In some embodiments of any of the methods, assays and/or kits, the PD-1binding antagonist is an antibody. In some embodiments of any of themethods, assays and/or kits, the antibody is a monoclonal antibody. Insome embodiments of any of the methods, assays and/or kits, the antibodyis a human, humanized or chimeric antibody.

In some embodiments of any of the methods, assays and/or kits, furthercomprising an effective amount of a second therapeutic selected from thegroup consisting of cytotoxic agent, a chemotherapeutic agent, a growthinhibitory agent, a radiation therapy agent, and anti-angiogenic agent,and combinations thereof.

Provided herein are methods for assessing a treatment response of anindividual with a PD-L1 axis binding antagonist, the method comprising:(a) determining the level(s) of one or more biomarkers in a biologicalsample derived from the individual at a time point during or afteradministration of the PD-L1 axis binding antagonist; and (b)maintaining, adjusting, or stopping the treatment of the individualbased on a comparison of the level(s) of one or more biomarkers in thebiological sample with reference levels, wherein a change in thelevel(s) of one or more biomarkers in the biological sample compared tothe reference levels is indicative of a response to treatment with thePD-L1 axis binding antagonist.

Provided herein are methods for monitoring the response of an individualtreated with a PD-L1 axis binding antagonist, said method comprising:(a) determining the level(s) of one or more biomarkers in a biologicalsample derived from the individual at a time point during or afteradministration of the PD-L1 axis binding antagonist; and (b) comparingthe level(s) of one or more biomarkers in the biological sample withreference levels in order to monitor the response in the individualsundergoing treatment with the PD-L1 axis binding antagonist.

In some embodiments, the reference levels of the one or more biomarkersis selected from the group consisting of (1) the level of the one ormore biomarkers from the individual prior to administration of the PD-L1axis binding antagonist; (2) the level of the one or more biomarkersfrom a reference population; (3) a pre-assigned level for the one ormore biomarkers; and (4) the level of the one or more biomarkers fromthe individual at a second time point prior to the first time point.

In some embodiments, the change in the level(s) of one or morebiomarkers in the biological sample compared to the reference levels isan increase in the levels.

In some embodiments, the change in the level(s) of one or morebiomarkers in the biological sample compared to the reference levels isa decrease in the levels.

In some embodiments, the one or more biomarkers is selected from thegroup consisting of PD-L1, PD-1, PD-L2 and any combinations thereof.

In some embodiments, the one or more biomarkers selected from the groupconsisting of PD-L1, PD-1, PD-L2 and any combinations thereof isincreased in the biological sample compared to the reference levels. Insome embodiments, an increase in one or more biomarkers selected fromthe group consisting of PD-L1, PD-1, PD-L2 and any combinations thereofin the biological sample compared to the reference levels is indicativeof a positive response to treatment.

In some embodiments, the one or more biomarkers is an immune relatedmarker. In some embodiments, the one or more biomarkers is a T-cellrelated marker.

In some embodiments, the one or more biomarkers is a T-cell activationmarker.

In some embodiments, the T-cell activation marker is increased in thebiological sample compared to the reference levels.

In some embodiments, the T-cell activation marker is selected from thegroup consisting of an CD8, IFN-g, Granzyme-A, TNF-a, perforin and anycombinations thereof. In some embodiments, an increase in the T-cellactivation marker selected from the group consisting of CD8, IFN-g,Granzyme-A, TNF-a, perforin and any combinations thereof in thebiological sample compared to the reference levels is indicative of apositive response to treatment.

In some embodiments, the one or more biomarkers is an activatedproliferating T cell.

In some embodiments, the activated proliferating T cell is increased inthe biological sample compared to the reference levels.

In some embodiments, the activated proliferating T cell is a CD8+/Ki67+cell, CD8+/HLA-DR+/Ki67+ cell and any combinations thereof.

In some embodiments, the one or more biomarkers is IL-6. In someembodiments, the IL-6 level is decreased in the biological samplecompared to the reference levels. In some embodiments, a decrease in theIL-6 level in the biological sample compared to the reference levels isindicative of a positive response to treatment. In some embodiments, theIL-6 level is increased in the biological sample compared to thereference levels. In some embodiments, an increase in the IL-6 level inthe biological sample compared to the reference levels is indicative ofa negative response to treatment.

In some embodiments, the biological sample derived from the individualis selected from the group consisting of a cell, a tissue, a tissueculture, a tumor, a biological fluid and combinations thereof.

In some embodiments, the biological fluid is selected from the groupconsisting of plasma, serum, whole blood, PBMCs and combinationsthereof.

In some embodiments, the tissue is a tumor tissue. In some embodiments,the tumor tissue is selected from the group consisting of tumor cells,tumor infiltrating cells, stromal cells and any combinations thereof.

In some embodiments, the cell is a circulating tumor cell (CTC).

In some embodiments, the individual suffers from a proliferative diseaseor disorder.

In some embodiments, the individual suffers from cancer or malignancy.In some embodiments, the cancer or malignancy is selected from non-smallcell lung cancer, small cell lung cancer, renal cell cancer, colorectalcancer, ovarian cancer, breast cancer, pancreatic cancer, gastriccarcinoma, bladder cancer, esophageal cancer, mesothelioma, melanoma,head and neck cancer, thyroid cancer, sarcoma, prostate cancer,glioblastoma, cervical cancer, thymic carcinoma, leukemia, lymphomas,myelomas, mycoses fungoids, merkel cell cancer, and other hematologicmalignancies.

In some embodiments, the individual suffers from an immune-relateddisease or disorder.

In some embodiments, the PD-L1 axis binding antagonist is a PD-L1binding antagonist.

In some embodiments, the PD-L1 binding antagonist inhibits the bindingof PD-L1 to its ligand binding partners.

In some embodiments, the PD-L1 binding antagonist inhibits the bindingof PD-L1 to PD-1. In some embodiments, the PD-L1 binding antagonistinhibits the binding of PD-L1 to B7-1. In some embodiments, the PD-L1binding antagonist inhibits the binding of PD-L1 to both PD-1 and B7-1.

In some embodiments, the PD-L1 binding antagonist is an antibody. Insome embodiments, the antibody is a monoclonal antibody. In someembodiments, the antibody is a human, humanized or chimeric antibody.

In some embodiments, the PD-L1 axis binding antagonist is a PD-1 bindingantagonist.

In some embodiments, the PD-1 binding antagonist inhibits the binding ofPD-1 to its ligand binding partners.

In some embodiments, the PD-1 binding antagonist inhibits the binding ofPD-1 to PD-L1. In some embodiments, the PD-1 binding antagonist inhibitsthe binding of PD-1 to PD-L2. In some embodiments, the PD-1 bindingantagonist inhibits the binding of PD-1 to both PD-L1 and PD-L2.

In some embodiments, the PD-1 binding antagonist is an antibody. In someembodiments, the antibody is a monoclonal antibody. In some embodiments,the antibody is a human, humanized or chimeric antibody.

BRIEF DESCRIPTION OF THE FIGURES

The patent or application file contains at least one drawing executed incolor. Copies of this patent or patent application publication withcolor drawing(s) will be provided by the Office upon request and paymentof the necessary fee.

FIG. 1 shows exemplary IHC analysis of control cell samples. (A)Negative control IHC staining of parental HEK-293 cells; (B) IHCstaining of HEK-293 cells transfected with recombinant human PD-L1 withweak staining intensity; (C) IHC staining of HEK-293 cells transfectedwith recombinant human PD-L1 with moderate staining intensity; (D) IHCstaining of HEK-293 cells transfected with recombinant human PD-L1 withstrong staining intensity; (E) Positive tissue control IHC staining ofplacental tissue sample; (F) Positive tissue control IHC staining oftonsil tissue sample. All IHC staining were performed using aproprietary anti-PD-L1 antibody.

FIG. 2 shows exemplary PD-L1 positive IHC staining of tumor samples from(A) Triple-Negative Breast Cancer; (B) Malignant Melanoma; (C) NSCLC,adenocarcinoma.

FIG. 3 shows the correlation of PD-L1 expression in tumor infiltratingimmune cells with either PD or PR/CR response to anti-PD-L1 treatment incancer patients. PD=progressive disease; PR=partial response;CR=complete response. (A) % of PD-L1+ tumor infiltrating immune cellswithin a tumor sample area, using PD-L1 IHC analysis. (B) % of PD-L1+ICwithin the total immune infiltrates within a tumor sample, using PD-L1IHC analysis.

FIG. 4 shows the correlation of PD-L1 gene expression in tumor sampleswith either PD or PR/CR response to anti-PD-L1 treatment in cancerpatients, using PD-L1 qPCR analysis. PD=progressive disease; PR=partialresponse; CR=complete response.

FIG. 5 shows the correlation of PD-1 gene expression in tumor sampleswith either PD or PR/CR response to anti-PD-L1 treatment in cancerpatients. PD=progressive disease; PR=partial response; CR=completeresponse.

FIG. 6 shows the correlation of various immune gene expressions in tumorsamples with either PD or PR response to anti-PD-L1 treatment in cancerpatients. PD=progressive disease; PR=partial response.

FIG. 7 shows a schematic of serial pre-on-treatment tumor biopsies frompatients treated with anti-PD-L1 antibody. Paired baseline (whichincludes either pre-treatment or archival tumor tissue) and on-treatmenttumor biopsies from patients treated with anti-PD-L1 antibody (n=26)suffering from various indications including melanoma, renal cellcarcinoma (RCC), non-small cell lung cancer (NSCLC), head and neckcancer (H&N), colorectal cancer (CRC), gastric, and breast cancer wereevaluated.

FIG. 8 shows (a) an increase in CD8+ T cell infiltration was associatedwith an increase in PD-L1 expression in tumor samples from patientsresponding to treatment with anti-PD-L1 antibody; and (b) an increase inT cell activation markers, including Granzyme A, Perforin, IFN-g, TNFaand CD8, following treatment with anti-PD-L1 antibody in patientsresponding to treatment with anti-PD-L1 antibody.

FIG. 9 summarizes changes in PD-L1 expression in patients undergoinganti-PD-L1 antibody treatment.

FIG. 10 shows (a) an increased frequency of proliferating T-cells inblood, identified as being CD8+/Ki67+ cells; and (b) an increasedfrequency of activated proliferating T-cells, identified as beingCD8+/HLA-DR+/Ki67+ cells, in patients undergoing treatment withanti-PD-L1 antibody.

FIG. 11 shows that a decrease in IL-6 levels in the plasma wasassociated with patients responding to the anti-PD-L1 antibody treatmentand that an increase in IL-6 levels in the plasma was associated withpatients progressing upon the anti-PD-L1 antibody treatment.

FIG. 12 shows the correlation of various immune gene expressions intumor samples with either PD or PR/CR response to anti-PD-L1 treatmentin cancer patients. PD=progressive disease; PR=partial response;CR=complete response.

FIG. 13 shows the correlation of IDO1 gene expressions in tumor samplesfrom either melanoma or NSCLC with either PD or PR/CR response toanti-PD-L1 treatment in cancer patients. PD=progressive disease;PR=partial response; CR=complete response.

FIG. 14 shows an increase in PD-L1 expression on circulating T cells inblood collected from patients responding to treatment with anti-PD-L1antibody. PD=progressive disease; PR=partial response; CR=completeresponse.

FIG. 15 shows correlation of gene expression of cytotoxic Th1 cells,IFN-g and T-cell trafficking markers in tumor samples with either PD orPR/CR response to anti-PD-L1 treatment in cancer patients.PD=progressive disease; PR=partial response; CR=complete response.

FIG. 16 shows an increase in T cell activation markers in a melanomapatient responding to treatment with anti-PD-L1 antibody.

FIG. 17 shows a low frequency of intratumoral T cells and lack of T cellactivation in T cell activation markers in a melanoma patient notresponding to treatment with anti-PD-L1 antibody.

FIG. 18 shows a transient increase in the frequency ofCD8+/HLA-DR+/Ki-67+ activated T cells in the blood of patientsresponding to treatment with anti-PD-L1 antibody.

FIG. 19 shows fluctuations in CD4+/ICOS+ T cells, with delayed increasesin this T cell population correlating with response and decreases withdisease progression (occurring after cycle 3).

FIG. 20 shows the adaptive increase in PD-L1 expression is prominent inpatients responding to treatment with anti-PD-L1 antibody.

FIG. 21 shows the correlation of CTLA4 expression with response totreatment with anti-PD-L1 antibody while the expression offractalkine/CX3CL1 correlated with progression.

FIG. 22 shows the correlation of gene signatures associated with Teff(T-effector) cells, Treg (T-regulatory) cells, and Th17 cells across sixcancer indications.

FIG. 23 shows a trend toward higher tumor gene expression of IL17F inpatients who do not respond to anti-PD-L1 treatment. R=Responders;nR=Non-responders.

FIG. 24 shows tumor gene expression of IL-17F is higher in patients witha late response to anti-PD-L1 treatment.

FIG. 25 shows transient increase in circulating CD8+/HLA-DR+/Ki67+ cellsin patients undergoing treatment with anti-PD-L1 antibody. (a) in UBCpatients, (b) in all patients.

FIG. 26 shows transient increase in plasma IL-18 in patients undergoingtreatment with anti-PD-L1 antibody. Furthermore, baseline plasma MCP-1was lower in patients with partial response/complete response (PR/CR) toanti-PD-L1 treatment. Both IL-18 and MCP-1 were also predominantlyexpressed in monocytes.

FIG. 27 shows that pretreatment tumors from patients that progressedfollowing treatment with anti-PD-L1 antibody displayed a proportionallyhigher myeloid gene signature (IL-8, CCL2, and IL1B) that werepredominantly expressed in myeloid cells (e.g., monocytes, dendriticcells)

FIG. 28 shows the correlation of soluble PD-L1 in the blood of patientsresponding to treatment with anti-PD-L1 antibody.

FIG. 29 shows the association between of PD-L1 expression in tumorinfiltrating immune cells (IC) and response to anti-PD-L1 treatment. (a)in NSCLC, (b) in all tumors.

FIG. 30 shows the association between of PD-L1 expression in tumor cellsand response to anti-PD-L1 treatment. (a) in NSCLC, (b) in all tumors.

DETAILED DESCRIPTION

Definitions

The term “PD-L1 axis binding antagonist” is a molecule that inhibits theinteraction of a PD-L1 axis binding partner with either one or more ofits binding partner, so as to remove T-cell dysfunction resulting fromsignaling on the PD-1 signaling axis—with a result being to restore orenhance T-cell function. As used herein, a PD-L1 axis binding antagonistincludes a PD-L1 binding antagonist and a PD-1 binding antagonist aswell as molecules that interfere with the interaction between PD-L1 andPD-1 (e.g., PD-L2-Fc fusion).

The term “PD-L1 binding antagonists” is a molecule that decreases,blocks, inhibits, abrogates or interferes with signal transductionresulting from the interaction of PD-L1 with either one or more of itsbinding partners, such as PD-1, B7-1. In some embodiments, a PD-L1binding antagonist is a molecule that inhibits the binding of PD-L1 toits binding partners. In a specific aspect, the PD-L1 binding antagonistinhibits binding of PD-L1 to PD-1 and/or B7-1. In some embodiments, thePD-L1 binding antagonists include anti-PD-L1 antibodies, antigen bindingfragments thereof, immunoadhesins, fusion proteins, oligopeptides andother molecules that decrease, block, inhibit, abrogate or interferewith signal transduction resulting from the interaction of PD-L1 withone or more of its binding partners, such as PD-1, B7-1. In oneembodiment, a PD-L1 binding antagonist reduces the negative signalmediated by or through cell surface proteins expressed on T lymphocytes,and other cells, mediated signaling through PD-L1 or PD-1 so as render adysfunctional T-cell less non-dysfunctional.

The term “PD-1 binding antagonists” is a molecule that decreases,blocks, inhibits, abrogates or interferes with signal transductionresulting from the interaction of PD-1 with one or more of its bindingpartners, such as PD-L1, PD-L2. In some embodiments, the PD-L1 bindingantagonist is a molecule that inhibits the binding of PD-1 to itsbinding partners. In a specific aspect, the PD-1 binding antagonistinhibits the binding of PD-1 to PD-L1 and/or PD-L2. For example, PD-1binding antagonists include anti-PD-1 antibodies, antigen bindingfragments thereof, immunoadhesins, fusion proteins, oligopeptides andother molecules that decrease, block, inhibit, abrogate or interferewith signal transduction resulting from the interaction of PD-1 withPD-L1 and/or PD-L2. In one embodiment, a PD-1 binding antagonist reducesthe negative signal mediated by or through cell surface proteinsexpressed on T lymphocytes, and other cells, mediated signaling throughPD-1 or PD-L1 so as render a dysfunctional T-cell lessnon-dysfunctional.

The terms “Programmed Death Ligand 1” and “PD-L1” refer herein to anative sequence PD-L1 polypeptide, polypeptide variants and fragments ofa native sequence polypeptide and polypeptide variants (which arefurther defined herein). The PD-L1 polypeptide described herein may bethat which is isolated from a variety of sources, such as from humantissue types or from another source, or prepared by recombinant orsynthetic methods.

A “native sequence PD-L1 polypeptide” comprises a polypeptide having thesame amino acid sequence as the corresponding PD-L1 polypeptide derivedfrom nature.

“PD-L1 polypeptide variant”, or variations thereof, means a PD-L1polypeptide, generally an active PD-L1 polypeptide, as defined hereinhaving at least about 80% amino acid sequence identity with any of thenative sequence PD-L1 polypeptide sequences as disclosed herein. SuchPD-L1 polypeptide variants include, for instance, PD-L1 polypeptideswherein one or more amino acid residues are added, or deleted, at the N-or C-terminus of a native amino acid sequence. Ordinarily, a PD-L1polypeptide variant will have at least about 80% amino acid sequenceidentity, alternatively at least about 81%, 82%, 83%, 84%, 85%, 86%,87%, 88%, 89%, 90%, 91%, 92%, 93%, 94%, 95%, 96%, 97%, 98%, or 99% aminoacid sequence identity, to a native sequence PD-L1 polypeptide sequenceas disclosed herein. Ordinarily, PD-L1 variant polypeptides are at leastabout 10 amino acids in length, alternatively at least about 20, 30, 40,50, 60, 70, 80, 90, 100, 110, 120, 130, 140, 150, 160, 170, 180, 190,200, 210, 220, 230, 240, 250, 260, 270, 280, 281, 282, 283, 284, 285,286, 287, 288, 289 amino acids in length, or more. Optionally, PD-L1variant polypeptides will have no more than one conservative amino acidsubstitution as compared to a native PD-L1 polypeptide sequence,alternatively no more than 2, 3, 4, 5, 6, 7, 8, 9, or 10 conservativeamino acid substitution as compared to the native PD-L1 polypeptidesequence.

The term “PD-L1 antagonist” as defined herein is any molecule thatpartially or fully blocks, inhibits, or neutralizes a biologicalactivity and/or function mediated by a native sequence PD-L1. In certainembodiments such antagonist binds to PD-L1. According to one embodiment,the antagonist is a polypeptide. According to another embodiment, theantagonist is an anti-PD-L1 antibody. According to another embodiment,the antagonist is a small molecule antagonist. According to anotherembodiment, the antagonist is a polynucleotide antagonist.

“Polynucleotide,” or “nucleic acid,” as used interchangeably herein,refer to polymers of nucleotides of any length, and include DNA and RNA.The nucleotides can be deoxyribonucleotides, ribonucleotides, modifiednucleotides or bases, and/or their analogs, or any substrate that can beincorporated into a polymer by DNA or RNA polymerase, or by a syntheticreaction. A polynucleotide may comprise modified nucleotides, such asmethylated nucleotides and their analogs. If present, modification tothe nucleotide structure may be imparted before or after assembly of thepolymer. The sequence of nucleotides may be interrupted bynon-nucleotide components. A polynucleotide may be further modifiedafter synthesis, such as by conjugation with a label. Other types ofmodifications include, for example, “caps”, substitution of one or moreof the naturally occurring nucleotides with an analog, internucleotidemodifications such as, for example, those with uncharged linkages (e.g.,methyl phosphonates, phosphotriesters, phosphoamidates, carbamates,etc.) and with charged linkages (e.g., phosphorothioates,phosphorodithioates, etc.), those containing pendant moieties, such as,for example, proteins (e.g., nucleases, toxins, antibodies, signalpeptides, ply-L-lysine, etc.), those with intercalators (e.g., acridine,psoralen, etc.), those containing chelators (e.g., metals, radioactivemetals, boron, oxidative metals, etc.), those containing alkylators,those with modified linkages (e.g., alpha anomeric nucleic acids, etc.),as well as unmodified forms of the polynucleotide(s). Further, any ofthe hydroxyl groups ordinarily present in the sugars may be replaced,for example, by phosphonate groups, phosphate groups, protected bystandard protecting groups, or activated to prepare additional linkagesto additional nucleotides, or may be conjugated to solid or semi-solidsupports. The 5′ and 3′ terminal OH can be phosphorylated or substitutedwith amines or organic capping group moieties of from 1 to 20 carbonatoms. Other hydroxyls may also be derivatized to standard protectinggroups. Polynucleotides can also contain analogous forms of ribose ordeoxyribose sugars that are generally known in the art, including, forexample, 2′-O-methyl-, 2′-O-allyl, 2′-fluoro- or 2′-azido-ribose,carbocyclic sugar analogs, α-anomeric sugars, epimeric sugars such asarabinose, xyloses or lyxoses, pyranose sugars, furanose sugars,sedoheptuloses, acyclic analogs and abasic nucleoside analogs such asmethyl riboside. One or more phosphodiester linkages may be replaced byalternative linking groups. These alternative linking groups include,but are not limited to, embodiments wherein phosphate is replaced byP(O)S(“thioate”), P(S)S (“dithioate”), “(O)NR₂ (“amidate”), P(O)R,P(O)OR′, CO or CH₂ (“formacetal”), in which each R or R′ isindependently H or substituted or unsubstituted alkyl (1-20 C)optionally containing an ether (—O—) linkage, aryl, alkenyl, cycloalkyl,cycloalkenyl or araldyl. Not all linkages in a polynucleotide need beidentical. The preceding description applies to all polynucleotidesreferred to herein, including RNA and DNA.

“Oligonucleotide,” as used herein, generally refers to short, singlestranded, polynucleotides that are, but not necessarily, less than about250 nucleotides in length. Oligonucleotides may be synthetic. The terms“oligonucleotide” and “polynucleotide” are not mutually exclusive. Thedescription above for polynucleotides is equally and fully applicable tooligonucleotides.

The term “primer” refers to a single stranded polynucleotide that iscapable of hybridizing to a nucleic acid and following polymerization ofa complementary nucleic acid, generally by providing a free 3′-OH group.

The term “small molecule” refers to any molecule with a molecular weightof about 2000 daltons or less, preferably of about 500 daltons or less.

The terms “host cell,” “host cell line,” and “host cell culture” areused interchangeably and refer to cells into which exogenous nucleicacid has been introduced, including the progeny of such cells. Hostcells include “transformants” and “transformed cells,” which include theprimary transformed cell and progeny derived therefrom without regard tothe number of passages. Progeny may not be completely identical innucleic acid content to a parent cell, but may contain mutations. Mutantprogeny that have the same function or biological activity as screenedor selected for in the originally transformed cell are included herein.

The term “vector,” as used herein, refers to a nucleic acid moleculecapable of propagating another nucleic acid to which it is linked. Theterm includes the vector as a self-replicating nucleic acid structure aswell as the vector incorporated into the genome of a host cell intowhich it has been introduced. Certain vectors are capable of directingthe expression of nucleic acids to which they are operatively linked.Such vectors are referred to herein as “expression vectors.”

An “isolated” antibody is one which has been separated from a componentof its natural environment. In some embodiments, an antibody is purifiedto greater than 95% or 99% purity as determined by, for example,electrophoretic (e.g., SDS-PAGE, isoelectric focusing (IEF), capillaryelectrophoresis) or chromatographic (e.g., ion exchange or reverse phaseHPLC). For review of methods for assessment of antibody purity, see,e.g., Flatman et al., J. Chromatogr. B 848:79-87 (2007).

An “isolated” nucleic acid refers to a nucleic acid molecule that hasbeen separated from a component of its natural environment. An isolatednucleic acid includes a nucleic acid molecule contained in cells thatordinarily contain the nucleic acid molecule, but the nucleic acidmolecule is present extrachromosomally or at a chromosomal location thatis different from its natural chromosomal location.

The term “antibody” herein is used in the broadest sense and encompassesvarious antibody structures, including but not limited to monoclonalantibodies, polyclonal antibodies, multispecific antibodies (e.g.,bispecific antibodies), and antibody fragments so long as they exhibitthe desired antigen-binding activity.

The terms “anti-PD-L1 antibody” and “an antibody that binds to PD-L1”refer to an antibody that is capable of binding PD-L1 with sufficientaffinity such that the antibody is useful as a diagnostic and/ortherapeutic agent in targeting PD-L1. In one embodiment, the extent ofbinding of an anti-PD-L1 antibody to an unrelated, non-PD-L1 protein isless than about 10% of the binding of the antibody to PD-L1 as measured,e.g., by a radioimmunoassay (RIA). In certain embodiments, an anti-PD-L1antibody binds to an epitope of PD-L1 that is conserved among PD-L1 fromdifferent species.

A “blocking” antibody or an “antagonist” antibody is one which inhibitsor reduces biological activity of the antigen it binds. Preferredblocking antibodies or antagonist antibodies substantially or completelyinhibit the biological activity of the antigen.

“Affinity” refers to the strength of the sum total of noncovalentinteractions between a single binding site of a molecule (e.g., anantibody) and its binding partner (e.g., an antigen). Unless indicatedotherwise, as used herein, “binding affinity” refers to intrinsicbinding affinity which reflects a 1:1 interaction between members of abinding pair (e.g., antibody and antigen). The affinity of a molecule Xfor its partner Y can generally be represented by the dissociationconstant (Kd). Affinity can be measured by common methods known in theart, including those described herein. Specific illustrative andexemplary embodiments for measuring binding affinity are described inthe following.

An “affinity matured” antibody refers to an antibody with one or morealterations in one or more hypervariable regions (HVRs), compared to aparent antibody which does not possess such alterations, suchalterations resulting in an improvement in the affinity of the antibodyfor antigen.

An “antibody fragment” refers to a molecule other than an intactantibody that comprises a portion of an intact antibody that binds theantigen to which the intact antibody binds. Examples of antibodyfragments include but are not limited to Fv, Fab, Fab′, Fab′-SH,F(ab′)₂; diabodies; linear antibodies; single-chain antibody molecules(e.g., scFv); and multispecific antibodies formed from antibodyfragments.

An “antibody that binds to the same epitope” as a reference antibodyrefers to an antibody that blocks binding of the reference antibody toits antigen in a competition assay by 50% or more, and conversely, thereference antibody blocks binding of the antibody to its antigen in acompetition assay by 50% or more. An exemplary competition assay isprovided herein.

The term “chimeric” antibody refers to an antibody in which a portion ofthe heavy and/or light chain is derived from a particular source orspecies, while the remainder of the heavy and/or light chain is derivedfrom a different source or species.

The “class” of an antibody refers to the type of constant domain orconstant region possessed by its heavy chain. There are five majorclasses of antibodies: IgA, IgD, IgE, IgG, and IgM, and several of thesemay be further divided into subclasses (isotypes), e.g., IgG₁, IgG₂,IgG₃, IgG₄, IgA₁, and IgA₂. The heavy chain constant domains thatcorrespond to the different classes of immunoglobulins are called α, δ,ε, γ, and μ, respectively.

The terms “full length antibody,” “intact antibody,” and “wholeantibody” are used herein interchangeably to refer to an antibody havinga structure substantially similar to a native antibody structure orhaving heavy chains that contain an Fc region as defined herein.

The term “monoclonal antibody” as used herein refers to an antibodyobtained from a population of substantially homogeneous antibodies,i.e., the individual antibodies comprising the population are identicaland/or bind the same epitope, except for possible variant antibodies,e.g., containing naturally occurring mutations or arising duringproduction of a monoclonal antibody preparation, such variants generallybeing present in minor amounts. In contrast to polyclonal antibodypreparations, which typically include different antibodies directedagainst different determinants (epitopes), each monoclonal antibody of amonoclonal antibody preparation is directed against a single determinanton an antigen. Thus, the modifier “monoclonal” indicates the characterof the antibody as being obtained from a substantially homogeneouspopulation of antibodies, and is not to be construed as requiringproduction of the antibody by any particular method. For example, themonoclonal antibodies to be used in accordance with the presentinvention may be made by a variety of techniques, including but notlimited to the hybridoma method, recombinant DNA methods, phage-displaymethods, and methods utilizing transgenic animals containing all or partof the human immunoglobulin loci, such methods and other exemplarymethods for making monoclonal antibodies being described herein.

A “human antibody” is one which possesses an amino acid sequence whichcorresponds to that of an antibody produced by a human or a human cellor derived from a non-human source that utilizes human antibodyrepertoires or other human antibody-encoding sequences. This definitionof a human antibody specifically excludes a humanized antibodycomprising non-human antigen-binding residues.

A “humanized” antibody refers to a chimeric antibody comprising aminoacid residues from non-human HVRs and amino acid residues from humanFRs. In certain embodiments, a humanized antibody will comprisesubstantially all of at least one, and typically two, variable domains,in which all or substantially all of the HVRs (e.g., CDRs) correspond tothose of a non-human antibody, and all or substantially all of the FRscorrespond to those of a human antibody. A humanized antibody optionallymay comprise at least a portion of an antibody constant region derivedfrom a human antibody. A “humanized form” of an antibody, e.g., anon-human antibody, refers to an antibody that has undergonehumanization.

An “immunoconjugate” is an antibody conjugated to one or moreheterologous molecule(s), including but not limited to a cytotoxicagent.

“Percent (%) amino acid sequence identity” with respect to a referencepolypeptide sequence is defined as the percentage of amino acid residuesin a candidate sequence that are identical with the amino acid residuesin the reference polypeptide sequence, after aligning the sequences andintroducing gaps, if necessary, to achieve the maximum percent sequenceidentity, and not considering any conservative substitutions as part ofthe sequence identity. Alignment for purposes of determining percentamino acid sequence identity can be achieved in various ways that arewithin the skill in the art, for instance, using publicly availablecomputer software such as BLAST, BLAST-2, ALIGN or Megalign (DNASTAR)software. Those skilled in the art can determine appropriate parametersfor aligning sequences, including any algorithms needed to achievemaximal alignment over the full length of the sequences being compared.For purposes herein, however, % amino acid sequence identity values aregenerated using the sequence comparison computer program ALIGN-2. TheALIGN-2 sequence comparison computer program was authored by Genentech,Inc., and the source code has been filed with user documentation in theU.S. Copyright Office, Washington D.C., 20559, where it is registeredunder U.S. Copyright Registration No. TXU510087. The ALIGN-2 program ispublicly available from Genentech, Inc., South San Francisco, Calif., ormay be compiled from the source code. The ALIGN-2 program should becompiled for use on a UNIX operating system, including digital UNIXV4.0D. All sequence comparison parameters are set by the ALIGN-2 programand do not vary.

In situations where ALIGN-2 is employed for amino acid sequencecomparisons, the % amino acid sequence identity of a given amino acidsequence A to, with, or against a given amino acid sequence B (which canalternatively be phrased as a given amino acid sequence A that has orcomprises a certain % amino acid sequence identity to, with, or againsta given amino acid sequence B) is calculated as follows:100 times the fraction X/Ywhere X is the number of amino acid residues scored as identical matchesby the sequence alignment program ALIGN-2 in that program's alignment ofA and B, and where Y is the total number of amino acid residues in B. Itwill be appreciated that where the length of amino acid sequence A isnot equal to the length of amino acid sequence B, the % amino acidsequence identity of A to B will not equal the % amino acid sequenceidentity of B to A. Unless specifically stated otherwise, all % aminoacid sequence identity values used herein are obtained as described inthe immediately preceding paragraph using the ALIGN-2 computer program.

The term “detection” includes any means of detecting, including directand indirect detection.

The term “biomarker” as used herein refers to an indicator, e.g.,predictive, diagnostic, and/or prognostic, which can be detected in asample. The biomarker may serve as an indicator of a particular subtypeof a disease or disorder (e.g., cancer) characterized by certain,molecular, pathological, histological, and/or clinical features. In someembodiments, a biomarker is a gene. Biomarkers include, but are notlimited to, polynucleotides (e.g., DNA, and/or RNA), polynucleotide copynumber alterations (e.g., DNA copy numbers), polypeptides, polypeptideand polynucleotide modifications (e.g. posttranslational modifications),carbohydrates, and/or glycolipid-based molecular markers.

The terms “biomarker signature,” “signature,” “biomarker expressionsignature,” or “expression signature” are used interchangeably hereinand refer to one or a combination of biomarkers whose expression is anindicator, e.g., predictive, diagnostic, and/or prognostic. Thebiomarker signature may serve as an indicator of a particular subtype ofa disease or disorder (e.g., cancer) characterized by certain molecular,pathological, histological, and/or clinical features. In someembodiments, the biomarker signature is a “gene signature.” The term“gene signature” is used interchangeably with “gene expressionsignature” and refers to one or a combination of polynucleotides whoseexpression is an indicator, e.g., predictive, diagnostic, and/orprognostic. In some embodiments, the biomarker signature is a “proteinsignature.” The term “protein signature” is used interchangeably with“protein expression signature” and refers to one or a combination ofpolypeptides whose expression is an indicator, e.g., predictive,diagnostic, and/or prognostic.

The “amount” or “level” of a biomarker associated with an increasedclinical benefit to an individual is a detectable level in a biologicalsample. These can be measured by methods known to one skilled in the artand also disclosed herein. The expression level or amount of biomarkerassessed can be used to determine the response to the treatment.

The terms “level of expression” or “expression level” in general areused interchangeably and generally refer to the amount of a biomarker ina biological sample. “Expression” generally refers to the process bywhich information (e.g., gene-encoded and/or epigenetic) is convertedinto the structures present and operating in the cell. Therefore, asused herein, “expression” may refer to transcription into apolynucleotide, translation into a polypeptide, or even polynucleotideand/or polypeptide modifications (e.g., posttranslational modificationof a polypeptide). Fragments of the transcribed polynucleotide, thetranslated polypeptide, or polynucleotide and/or polypeptidemodifications (e.g., posttranslational modification of a polypeptide)shall also be regarded as expressed whether they originate from atranscript generated by alternative splicing or a degraded transcript,or from a post-translational processing of the polypeptide, e.g., byproteolysis. “Expressed genes” include those that are transcribed into apolynucleotide as mRNA and then translated into a polypeptide, and alsothose that are transcribed into RNA but not translated into apolypeptide (for example, transfer and ribosomal RNAs).

“Elevated expression,” “elevated expression levels,” or “elevatedlevels” refers to an increased expression or increased levels of abiomarker in an individual relative to a control, such as an individualor individuals who are not suffering from the disease or disorder (e.g.,cancer) or an internal control (e.g., housekeeping biomarker).

“Reduced expression,” “reduced expression levels,” or “reduced levels”refers to a decrease expression or decreased levels of a biomarker in anindividual relative to a control, such as an individual or individualswho are not suffering from the disease or disorder (e.g., cancer) or aninternal control (e.g., housekeeping biomarker). In some embodiments,reduced expression is little or no expression.

The term “housekeeping biomarker” refers to a biomarker or group ofbiomarkers (e.g., polynucleotides and/or polypeptides) which aretypically similarly present in all cell types. In some embodiments, thehousekeeping biomarker is a “housekeeping gene.” A “housekeeping gene”refers herein to a gene or group of genes which encode proteins whoseactivities are essential for the maintenance of cell function and whichare typically similarly present in all cell types.

“Amplification,” as used herein generally refers to the process ofproducing multiple copies of a desired sequence. “Multiple copies” meanat least two copies. A “copy” does not necessarily mean perfect sequencecomplementarity or identity to the template sequence. For example,copies can include nucleotide analogs such as deoxyinosine, intentionalsequence alterations (such as sequence alterations introduced through aprimer comprising a sequence that is hybridizable, but notcomplementary, to the template), and/or sequence errors that occurduring amplification.

The term “multiplex-PCR” refers to a single PCR reaction carried out onnucleic acid obtained from a single source (e.g., an individual) usingmore than one primer set for the purpose of amplifying two or more DNAsequences in a single reaction.

“Stringency” of hybridization reactions is readily determinable by oneof ordinary skill in the art, and generally is an empirical calculationdependent upon probe length, washing temperature, and saltconcentration. In general, longer probes require higher temperatures forproper annealing, while shorter probes need lower temperatures.Hybridization generally depends on the ability of denatured DNA toreanneal when complementary strands are present in an environment belowtheir melting temperature. The higher the degree of desired homologybetween the probe and hybridizable sequence, the higher the relativetemperature which can be used. As a result, it follows that higherrelative temperatures would tend to make the reaction conditions morestringent, while lower temperatures less so. For additional details andexplanation of stringency of hybridization reactions, see Ausubel etal., Current Protocols in Molecular Biology, Wiley IntersciencePublishers, (1995).

“Stringent conditions” or “high stringency conditions”, as definedherein, can be identified by those that: (1) employ low ionic strengthand high temperature for washing, for example 0.015 M sodiumchloride/0.0015 M sodium citrate/0.1% sodium dodecyl sulfate at 50° C.;(2) employ during hybridization a denaturing agent, such as formamide,for example, 50% (v/v) formamide with 0.1% bovine serum albumin/0.1%Fico11/0.1% polyvinylpyrrolidone/50 mM sodium phosphate buffer at pH 6.5with 750 mM sodium chloride, 75 mM sodium citrate at 42° C.; or (3)overnight hybridization in a solution that employs 50% formamide, 5×SSC(0.75 M NaCl, 0.075 M sodium citrate), 50 mM sodium phosphate (pH 6.8),0.1% sodium pyrophosphate, 5×Denhardt's solution, sonicated salmon spermDNA (50 μg/ml), 0.1% SDS, and 10% dextran sulfate at 42° C., with a 10minute wash at 42° C. in 0.2×SSC (sodium chloride/sodium citrate)followed by a 10 minute high-stringency wash consisting of 0.1×SSCcontaining EDTA at 55° C.

“Moderately stringent conditions” can be identified as described bySambrook et al., Molecular Cloning: A Laboratory Manual, New York: ColdSpring Harbor Press, 1989, and include the use of washing solution andhybridization conditions (e.g., temperature, ionic strength and % SDS)less stringent that those described above. An example of moderatelystringent conditions is overnight incubation at 37° C. in a solutioncomprising: 20% formamide, 5×SSC (150 mM NaCl, 15 mM trisodium citrate),50 mM sodium phosphate (pH 7.6), 5×Denhardt's solution, 10% dextransulfate, and 20 mg/ml denatured sheared salmon sperm DNA, followed bywashing the filters in 1×SSC at about 37-50° C. The skilled artisan willrecognize how to adjust the temperature, ionic strength, etc. asnecessary to accommodate factors such as probe length and the like.

The technique of “polymerase chain reaction” or “PCR” as used hereingenerally refers to a procedure wherein minute amounts of a specificpiece of nucleic acid, RNA and/or DNA, are amplified as described inU.S. Pat. No. 4,683,195 issued 28 Jul. 1987. Generally, sequenceinformation from the ends of the region of interest or beyond needs tobe available, such that oligonucleotide primers can be designed; theseprimers will be identical or similar in sequence to opposite strands ofthe template to be amplified. The 5′ terminal nucleotides of the twoprimers may coincide with the ends of the amplified material. PCR can beused to amplify specific RNA sequences, specific DNA sequences fromtotal genomic DNA, and cDNA transcribed from total cellular RNA,bacteriophage or plasmid sequences, etc. See generally Mullis et al.,Cold Spring Harbor Symp. Quant. Biol., 51: 263 (1987); Erlich, ed., PCRTechnology, (Stockton Press, N.Y., 1989). As used herein, PCR isconsidered to be one, but not the only, example of a nucleic acidpolymerase reaction method for amplifying a nucleic acid test sample,comprising the use of a known nucleic acid (DNA or RNA) as a primer andutilizes a nucleic acid polymerase to amplify or generate a specificpiece of nucleic acid or to amplify or generate a specific piece ofnucleic acid which is complementary to a particular nucleic acid.

“Quantitative real time polymerase chain reaction” or “qRT-PCR” refersto a form of PCR wherein the amount of PCR product is measured at eachstep in a PCR reaction. This technique has been described in variouspublications including Cronin et al., Am. J. Pathol. 164(1):35-42(2004); and Ma et al., Cancer Cell 5:607-616 (2004).

The term “microarray” refers to an ordered arrangement of hybridizablearray elements, preferably polynucleotide probes, on a substrate.

The term “polynucleotide,” when used in singular or plural, generallyrefers to any polyribonucleotide or polydeoxyribonucleotide, which maybe unmodified RNA or DNA or modified RNA or DNA. Thus, for instance,polynucleotides as defined herein include, without limitation, single-and double-stranded DNA, DNA including single- and double-strandedregions, single- and double-stranded RNA, and RNA including single- anddouble-stranded regions, hybrid molecules comprising DNA and RNA thatmay be single-stranded or, more typically, double-stranded or includesingle- and double-stranded regions. In addition, the term“polynucleotide” as used herein refers to triple-stranded regionscomprising RNA or DNA or both RNA and DNA. The strands in such regionsmay be from the same molecule or from different molecules. The regionsmay include all of one or more of the molecules, but more typicallyinvolve only a region of some of the molecules. One of the molecules ofa triple-helical region often is an oligonucleotide. The term“polynucleotide” specifically includes cDNAs. The term includes DNAs(including cDNAs) and RNAs that contain one or more modified bases.Thus, DNAs or RNAs with backbones modified for stability or for otherreasons are “polynucleotides” as that term is intended herein. Moreover,DNAs or RNAs comprising unusual bases, such as inosine, or modifiedbases, such as tritiated bases, are included within the term“polynucleotides” as defined herein. In general, the term“polynucleotide” embraces all chemically, enzymatically and/ormetabolically modified forms of unmodified polynucleotides, as well asthe chemical forms of DNA and RNA characteristic of viruses and cells,including simple and complex cells.

The term “oligonucleotide” refers to a relatively short polynucleotide,including, without limitation, single-stranded deoxyribonucleotides,single- or double-stranded ribonucleotides, RNA:DNA hybrids anddouble-stranded DNAs. Oligonucleotides, such as single-stranded DNAprobe oligonucleotides, are often synthesized by chemical methods, forexample using automated oligonucleotide synthesizers that arecommercially available. However, oligonucleotides can be made by avariety of other methods, including in vitro recombinant DNA-mediatedtechniques and by expression of DNAs in cells and organisms.

The term “diagnosis” is used herein to refer to the identification orclassification of a molecular or pathological state, disease orcondition (e.g., cancer). For example, “diagnosis” may refer toidentification of a particular type of cancer. “Diagnosis” may alsorefer to the classification of a particular subtype of cancer, e.g., byhistopathological criteria, or by molecular features (e.g., a subtypecharacterized by expression of one or a combination of biomarkers (e.g.,particular genes or proteins encoded by said genes)).

The term “aiding diagnosis” is used herein to refer to methods thatassist in making a clinical determination regarding the presence, ornature, of a particular type of symptom or condition of a disease ordisorder (e.g., cancer). For example, a method of aiding diagnosis of adisease or condition (e.g., cancer) can comprise measuring certainbiomarkers in a biological sample from an individual.

The term “sample,” as used herein, refers to a composition that isobtained or derived from a subject and/or individual of interest thatcontains a cellular and/or other molecular entity that is to becharacterized and/or identified, for example based on physical,biochemical, chemical and/or physiological characteristics. For example,the phrase “disease sample” and variations thereof refers to any sampleobtained from a subject of interest that would be expected or is knownto contain the cellular and/or molecular entity that is to becharacterized. Samples include, but are not limited to, primary orcultured cells or cell lines, cell supernatants, cell lysates,platelets, serum, plasma, vitreous fluid, lymph fluid, synovial fluid,follicular fluid, seminal fluid, amniotic fluid, milk, whole blood,blood-derived cells, urine, cerebro-spinal fluid, saliva, sputum, tears,perspiration, mucus, tumor lysates, and tissue culture medium, tissueextracts such as homogenized tissue, tumor tissue, cellular extracts,and combinations thereof.

By “tissue sample” or “cell sample” is meant a collection of similarcells obtained from a tissue of a subject or individual. The source ofthe tissue or cell sample may be solid tissue as from a fresh, frozenand/or preserved organ, tissue sample, biopsy, and/or aspirate; blood orany blood constituents such as plasma; bodily fluids such as cerebralspinal fluid, amniotic fluid, peritoneal fluid, or interstitial fluid;cells from any time in gestation or development of the subject. Thetissue sample may also be primary or cultured cells or cell lines.Optionally, the tissue or cell sample is obtained from a diseasetissue/organ. The tissue sample may contain compounds which are notnaturally intermixed with the tissue in nature such as preservatives,anticoagulants, buffers, fixatives, nutrients, antibiotics, or the like.

A “reference sample”, “reference cell”, “reference tissue”, “controlsample”, “control cell”, or “control tissue”, as used herein, refers toa sample, cell, tissue, standard, or level that is used for comparisonpurposes. In one embodiment, a reference sample, reference cell,reference tissue, control sample, control cell, or control tissue isobtained from a healthy and/or non-diseased part of the body (e.g.,tissue or cells) of the same subject or individual. For example, healthyand/or non-diseased cells or tissue adjacent to the diseased cells ortissue (e.g., cells or tissue adjacent to a tumor). In anotherembodiment, a reference sample is obtained from an untreated tissueand/or cell of the body of the same subject or individual. In yetanother embodiment, a reference sample, reference cell, referencetissue, control sample, control cell, or control tissue is obtained froma healthy and/or non-diseased part of the body (e.g., tissues or cells)of an individual who is not the subject or individual. In even anotherembodiment, a reference sample, reference cell, reference tissue,control sample, control cell, or control tissue is obtained from anuntreated tissue and/or cell of the body of an individual who is not thesubject or individual.

For the purposes herein a “section” of a tissue sample is meant a singlepart or piece of a tissue sample, e.g. a thin slice of tissue or cellscut from a tissue sample. It is understood that multiple sections oftissue samples may be taken and subjected to analysis, provided that itis understood that the same section of tissue sample may be analyzed atboth morphological and molecular levels, or analyzed with respect toboth polypeptides and polynucleotides.

By “correlate” or “correlating” is meant comparing, in any way, theperformance and/or results of a first analysis or protocol with theperformance and/or results of a second analysis or protocol. Forexample, one may use the results of a first analysis or protocol incarrying out a second protocols and/or one may use the results of afirst analysis or protocol to determine whether a second analysis orprotocol should be performed. With respect to the embodiment ofpolypeptide analysis or protocol, one may use the results of thepolypeptide expression analysis or protocol to determine whether aspecific therapeutic regimen should be performed. With respect to theembodiment of polynucleotide analysis or protocol, one may use theresults of the polynucleotide expression analysis or protocol todetermine whether a specific therapeutic regimen should be performed.

“Individual response” or “response” can be assessed using any endPointindicating a benefit to the individual, including, without limitation,(1) inhibition, to some extent, of disease progression (e.g., cancerprogression), including slowing down and complete arrest; (2) areduction in tumor size; (3) inhibition (i.e., reduction, slowing downor complete stopping) of cancer cell infiltration into adjacentperipheral organs and/or tissues; (4) inhibition (i.e. reduction,slowing down or complete stopping) of metastasis; (5) relief, to someextent, of one or more symptoms associated with the disease or disorder(e.g., cancer); (6) increase or extend in the length of survival,including overall survival and progression free survival; and/or (9)decreased mortality at a given Point of time following treatment.

An “effective response” of a patient or a patient's “responsiveness” totreatment with a medicament and similar wording refers to the clinicalor therapeutic benefit imparted to a patient at risk for, or sufferingfrom, a disease or disorder, such as cancer. In one embodiment, suchbenefit includes any one or more of: extending survival (includingoverall survival and progression free survival); resulting in anobjective response (including a complete response or a partialresponse); or improving signs or symptoms of cancer. In one embodiment,the biomarker (e.g., PD-L1 expression, for example, as determined usingIHC) is used to identify the patient who is predicted to have anincrease likelihood of being responsive to treatment with a medicament(e.g., anti-PD-L1 antibody), relative to a patient who does not expressthe biomarker. In one embodiment, the biomarker (e.g., PD-L1 expression,for example, as determined using IHC) is used to identify the patientwho is predicted to have an increase likelihood of being responsive totreatment with a medicament (e.g., anti-PD-L1 antibody), relative to apatient who does not express the biomarker at the same level. In oneembodiment, the presence of the biomarker is used to identify a patientwho is more likely to respond to treatment with a medicament, relativeto a patient that does not have the presence of the biomarker. Inanother embodiment, the presence of the biomarker is used to determinethat a patient will have an increase likelihood of benefit fromtreatment with a medicament, relative to a patient that does not havethe presence of the biomarker.

Survival” refers to the patient remaining alive, and includes overallsurvival as well as progression free survival.

Overall survival refers to the patient remaining alive for a definedperiod of time, such as 1 year, 5 years, etc from the time of diagnosisor treatment.

Progression free survival refers to the patient remaining alive, withoutthe cancer progressing or getting worse.

By “extending survival” is meant increasing overall or progression freesurvival in a treated patient relative to an untreated patient (i.e.relative to a patient not treated with the medicament), or relative to apatient who does not express a biomarker at the designated level, and/orrelative to a patient treated with an approved anti-tumor agent. Anobjective response refers to a measurable response, including completeresponse (CR) or partial response (PR).

By complete response or “CR” is intended the disappearance of all signsof cancer in response to treatment. This does not always mean the cancerhas been cured.

Partial response or “PR” refers to a decrease in the size of one or moretumors or lesions, or in the extent of cancer in the body, in responseto treatment.

The term “substantially the same,” as used herein, denotes asufficiently high degree of similarity between two numeric values, suchthat one of skill in the art would consider the difference between thetwo values to be of little or no biological and/or statisticalsignificance within the context of the biological characteristicmeasured by said values (e.g., Kd values or expression). The differencebetween said two values is, for example, less than about 50%, less thanabout 40%, less than about 30%, less than about 20%, and/or less thanabout 10% as a function of the reference/comparator value.

The phrase “substantially different,” as used herein, denotes asufficiently high degree of difference between two numeric values suchthat one of skill in the art would consider the difference between thetwo values to be of statistical significance within the context of thebiological characteristic measured by said values (e.g., Kd values). Thedifference between said two values is, for example, greater than about10%, greater than about 20%, greater than about 30%, greater than about40%, and/or greater than about 50% as a function of the value for thereference/comparator molecule.

The word “label” when used herein refers to a detectable compound orcomposition. The label is typically conjugated or fused directly orindirectly to a reagent, such as a polynucleotide probe or an antibody,and facilitates detection of the reagent to which it is conjugated orfused. The label may itself be detectable (e.g., radioisotope labels orfluorescent labels) or, in the case of an enzymatic label, may catalyzechemical alteration of a substrate compound or composition which resultsin a detectable product.

An “effective amount” of an agent refers to an amount effective, atdosages and for periods of time necessary, to achieve the desiredtherapeutic or prophylactic result.

A “therapeutically effective amount” refers to an amount of atherapeutic agent to treat or prevent a disease or disorder in a mammal.In the case of cancers, the therapeutically effective amount of thetherapeutic agent may reduce the number of cancer cells; reduce theprimary tumor size; inhibit (i.e., slow to some extent and preferablystop) cancer cell infiltration into peripheral organs; inhibit (i.e.,slow to some extent and preferably stop) tumor metastasis; inhibit, tosome extent, tumor growth; and/or relieve to some extent one or more ofthe symptoms associated with the disorder. To the extent the drug mayprevent growth and/or kill existing cancer cells, it may be cytostaticand/or cytotoxic. For cancer therapy, efficacy in vivo can, for example,be measured by assessing the duration of survival, time to diseaseprogression (TTP), the response rates (RR), duration of response, and/orquality of life.

The terms “cancer” and “cancerous” refer to or describe thephysiological condition in mammals that is typically characterized byunregulated cell growth. Included in this definition are benign andmalignant cancers. By “early stage cancer” or “early stage tumor” ismeant a cancer that is not invasive or metastatic or is classified as aStage 0, I, or II cancer. Examples of cancer include, but are notlimited to, carcinoma, lymphoma, blastoma (including medulloblastoma andretinoblastoma), sarcoma (including liposarcoma and synovial cellsarcoma), neuroendocrine tumors (including carcinoid tumors, gastrinoma,and islet cell cancer), mesothelioma, schwannoma (including acousticneuroma), meningioma, adenocarcinoma, melanoma, and leukemia or lymphoidmalignancies. More particular examples of such cancers include squamouscell cancer (e.g. epithelial squamous cell cancer), lung cancerincluding small-cell lung cancer (SCLC), non-small cell lung cancer(NSCLC), adenocarcinoma of the lung and squamous carcinoma of the lung,cancer of the peritoneum, hepatocellular cancer, gastric or stomachcancer including gastrointestinal cancer, pancreatic cancer,glioblastoma, cervical cancer, ovarian cancer, liver cancer, bladdercancer, hepatoma, breast cancer (including metastatic breast cancer),colon cancer, rectal cancer, colorectal cancer, endometrial or uterinecarcinoma, salivary gland carcinoma, kidney or renal cancer, prostatecancer, vulval cancer, thyroid cancer, hepatic carcinoma, analcarcinoma, penile carcinoma, merkel cell cancer, mycoses fungoids,testicular cancer, esophageal cancer, tumors of the biliary tract, aswell as head and neck cancer and hematological malignancies. In someembodiments, the cancer is triple-negative metastatic breast cancer,including any histologically confirmed triple-negative (ER-, PR-, HER2-)adenocarcinoma of the breast with locally recurrent or metastaticdisease (where the locally recurrent disease is not amenable toresection with curative intent).

The term “pharmaceutical formulation” refers to a preparation which isin such form as to permit the biological activity of an activeingredient contained therein to be effective, and which contains noadditional components which are unacceptably toxic to a subject to whichthe formulation would be administered.

A “pharmaceutically acceptable carrier” refers to an ingredient in apharmaceutical formulation, other than an active ingredient, which isnontoxic to a subject. A pharmaceutically acceptable carrier includes,but is not limited to, a buffer, excipient, stabilizer, or preservative.

As used herein, “treatment” (and grammatical variations thereof such as“treat” or “treating”) refers to clinical intervention in an attempt toalter the natural course of the individual being treated, and can beperformed either for prophylaxis or during the course of clinicalpathology. Desirable effects of treatment include, but are not limitedto, preventing occurrence or recurrence of disease, alleviation ofsymptoms, diminishment of any direct or indirect pathologicalconsequences of the disease, preventing metastasis, decreasing the rateof disease progression, amelioration or palliation of the disease state,and remission or improved prognosis. In some embodiments, antibodies areused to delay development of a disease or to slow the progression of adisease.

The term “anti-cancer therapy” refers to a therapy useful in treatingcancer. Examples of anti-cancer therapeutic agents include, but arelimited to, e.g., chemotherapeutic agents, growth inhibitory agents,cytotoxic agents, agents used in radiation therapy, anti-angiogenesisagents, apoptotic agents, anti-tubulin agents, and other agents to treatcancer, anti-CD20 antibodies, platelet derived growth factor inhibitors(e.g., Gleevec™ (Imatinib Mesylate)), a COX-2 inhibitor (e.g.,celecoxib), interferons, cytokines, antagonists (e.g., neutralizingantibodies) that bind to one or more of the following targetsPDGFR-beta, BlyS, APRIL, BCMA receptor(s), TRAIL/Apo2, and otherbioactive and organic chemical agents, etc. Combinations thereof arealso included in the invention.

The term “cytotoxic agent” as used herein refers to a substance thatinhibits or prevents the function of cells and/or causes destruction ofcells. The term is intended to include radioactive isotopes (e.g.,At²¹¹, I¹³¹, I¹²⁵, Y⁹⁰, Re¹⁸⁶, Re¹⁸⁸, Sm¹⁵³, Bi²¹², P³² and radioactiveisotopes of Lu), chemotherapeutic agents e.g., methotrexate, adriamicin,vinca alkaloids (vincristine, vinblastine, etoposide), doxorubicin,melphalan, mitomycin C, chlorambucil, daunorubicin or otherintercalating agents, enzymes and fragments thereof such as nucleolyticenzymes, antibiotics, and toxins such as small molecule toxins orenzymatically active toxins of bacterial, fungal, plant or animalorigin, including fragments and/or variants thereof, and the variousantitumor or anticancer agents disclosed below. Other cytotoxic agentsare described below. A tumoricidal agent causes destruction of tumorcells.

A “chemotherapeutic agent” refers to a chemical compound useful in thetreatment of cancer. Examples of chemotherapeutic agents includealkylating agents such as thiotepa and cyclosphosphamide (CYTOXAN®);alkyl sulfonates such as busulfan, improsulfan and piposulfan;aziridines such as benzodopa, carboquone, meturedopa, and uredopa;ethylenimines and methylamelamines including altretamine,triethylenemelamine, triethylenephosphoramide,triethylenethiophosphoramide and trimethylomelamine; acetogenins(especially bullatacin and bullatacinone); delta-9-tetrahydrocannabinol(dronabinol, MARINOL®); beta-lapachone; lapachol; colchicines; betulinicacid; a camptothecin (including the synthetic analogue topotecan(HYCAMTIN®), CPT-11 (irinotecan, CAMPTOSAR®), acetylcamptothecin,scopolectin, and 9-aminocamptothecin); bryostatin; callystatin; CC-1065(including its adozelesin, carzelesin and bizelesin syntheticanalogues); podophyllotoxin; podophyllinic acid; teniposide;cryptophycins (particularly cryptophycin 1 and cryptophycin 8);dolastatin; duocarmycin (including the synthetic analogues, KW-2189 andCB1-TM1); eleutherobin; pancratistatin; a sarcodictyin; spongistatin;nitrogen mustards such as chlorambucil, chlornaphazine,chlorophosphamide, estramustine, ifosfamide, mechlorethamine,mechlorethamine oxide hydrochloride, melphalan, novembichin,phenesterine, prednimustine, trofosfamide, uracil mustard; nitrosoureassuch as carmustine, chlorozotocin, fotemustine, lomustine, nimustine,and ranimnustine; antibiotics such as the enediyne antibiotics (e.g.,calicheamicin, especially calicheamicin gamma1I and calicheamicinomegaI1 (see, e.g., Nicolaou et al., Angew. Chem Intl. Ed. Engl., 33:183-186 (1994)); CDP323, an oral alpha-4 integrin inhibitor; dynemicin,including dynemicin A; an esperamicin; as well as neocarzinostatinchromophore and related chromoprotein enediyne antibiotic chromophores),aclacinomysins, actinomycin, authramycin, azaserine, bleomycins,cactinomycin, carabicin, carminomycin, carzinophilin, chromomycins,dactinomycin, daunorubicin, detorubicin, 6-diazo-5-oxo-L-norleucine,doxorubicin (including ADRIAMYCIN®, morpholino-doxorubicin,cyanomorpholino-doxorubicin, 2-pyrrolino-doxorubicin, doxorubicin HC1liposome injection (DOXIL®), liposomal doxorubicin TLC D-99 (MYOCET®),peglylated liposomal doxorubicin (CAELYX®), and deoxydoxorubicin),epirubicin, esorubicin, idarubicin, marcellomycin, mitomycins such asmitomycin C, mycophenolic acid, nogalamycin, olivomycins, peplomycin,porfiromycin, puromycin, quelamycin, rodorubicin, streptonigrin,streptozocin, tubercidin, ubenimex, zinostatin, zorubicin;anti-metabolites such as methotrexate, gemcitabine (GEMZAR®), tegafur(UFTORAL®), capecitabine (XELODA®), an epothilone, and 5-fluorouracil(5-FU); folic acid analogues such as denopterin, methotrexate,pteropterin, trimetrexate; purine analogs such as fludarabine,6-mercaptopurine, thiamiprine, thioguanine; pyrimidine analogs such asancitabine, azacitidine, 6-azauridine, carmofur, cytarabine,dideoxyuridine, doxifluridine, enocitabine, floxuridine; androgens suchas calusterone, dromostanolone propionate, epitiostanol, mepitiostane,testolactone; anti-adrenals such as aminoglutethimide, mitotane,trilostane; folic acid replenisher such as frolinic acid; aceglatone;aldophosphamide glycoside; aminolevulinic acid; eniluracil; amsacrine;bestrabucil; bisantrene; edatraxate; defofamine; demecolcine;diaziquone; elfornithine; elliptinium acetate; an epothilone; etoglucid;gallium nitrate; hydroxyurea; lentinan; lonidainine; maytansinoids suchas maytansine and ansamitocins; mitoguazone; mitoxantrone; mopidanmol;nitraerine; pentostatin; phenamet; pirarubicin; losoxantrone;2-ethylhydrazide; procarbazine; PSK® polysaccharide complex (JHS NaturalProducts, Eugene, Oreg.); razoxane; rhizoxin; sizofiran; spirogermanium;tenuazonic acid; triaziquone; 2,2′,2′-trichlorotriethylamine;trichothecenes (especially T-2 toxin, verracurin A, roridin A andanguidine); urethan; vindesine (ELDISINE®, FILDESIN®); dacarbazine;mannomustine; mitobronitol; mitolactol; pipobroman; gacytosine;arabinoside (“Ara-C”); thiotepa; taxoid, e.g., paclitaxel (TAXOL®),albumin-engineered nanoparticle formulation of paclitaxel (ABRAXANE™),and docetaxel (TAXOTERE®); chloranbucil; 6-thioguanine; mercaptopurine;methotrexate; platinum agents such as cisplatin, oxaliplatin (e.g.,ELOXATIN®), and carboplatin; vincas, which prevent tubulinpolymerization from forming microtubules, including vinblastine(VELBAN®), vincristine (ONCOVIN®), vindesine (ELDISINE®, FILDESIN®), andvinorelbine (NAVELBINE®); etoposide (VP-16); ifosfamide; mitoxantrone;leucovorin; novantrone; edatrexate; daunomycin; aminopterin;ibandronate; topoisomerase inhibitor RFS 2000; difluoromethylornithine(DMFO); retinoids such as retinoic acid, including bexarotene(TARGRETIN®); bisphosphonates such as clodronate (for example, BONEFOS®or OSTAC®), etidronate (DIDROCAL®), NE-58095, zoledronicacid/zoledronate (ZOMETA®), alendronate (FOSAMAX®), pamidronate(AREDIA®), tiludronate (SKELID®), or risedronate (ACTONEL®);troxacitabine (a 1,3-dioxolane nucleoside cytosine analog); antisenseoligonucleotides, particularly those that inhibit expression of genes insignaling pathways implicated in aberrant cell proliferation, such as,for example, PKC-alpha, Raf, H-Ras, and epidermal growth factor receptor(EGF-R); vaccines such as THERATOPE® vaccine and gene therapy vaccines,for example, ALLOVECTIN® vaccine, LEUVECTIN® vaccine, and VAXID®vaccine; topoisomerase 1 inhibitor (e.g., LURTOTECAN®); rmRH (e.g.,ABARELIX®); BAY439006 (sorafenib; Bayer); SU-11248 (sunitinib, SUTENT®,Pfizer); perifosine, COX-2 inhibitor (e.g., celecoxib or etoricoxib),proteosome inhibitor (e.g., PS341); bortezomib (VELCADE®); CCI-779;tipifarnib (R11577); orafenib, ABT510; Bcl-2 inhibitor such asoblimersen sodium (GENASENSE®); pixantrone; EGFR inhibitors (seedefinition below); tyrosine kinase inhibitors (see definition below);serine-threonine kinase inhibitors such as rapamycin (sirolimus,RAPAMUNE®); farnesyltransferase inhibitors such as lonafarnib (SCH 6636,SARASAR™); and pharmaceutically acceptable salts, acids or derivativesof any of the above; as well as combinations of two or more of the abovesuch as CHOP, an abbreviation for a combined therapy ofcyclophosphamide, doxorubicin, vincristine, and prednisolone; andFOLFOX, an abbreviation for a treatment regimen with oxaliplatin(ELOXATIN™) combined with 5-FU and leucovorin.

Chemotherapeutic agents as defined herein include “anti-hormonal agents”or “endocrine therapeutics” which act to regulate, reduce, block, orinhibit the effects of hormones that can promote the growth of cancer.They may be hormones themselves, including, but not limited to:anti-estrogens with mixed agonist/antagonist profile, including,tamoxifen (NOLVADEX®), 4-hydroxytamoxifen, toremifene (FARESTON®),idoxifene, droloxifene, raloxifene (EVISTA®), trioxifene, keoxifene, andselective estrogen receptor modulators (SERMs) such as SERM3; pureanti-estrogens without agonist properties, such as fulvestrant(FASLODEX®), and EM800 (such agents may block estrogen receptor (ER)dimerization, inhibit DNA binding, increase ER turnover, and/or suppressER levels); aromatase inhibitors, including steroidal aromataseinhibitors such as formestane and exemestane (AROMASIN®), andnonsteroidal aromatase inhibitors such as anastrazole (ARIMIDEX®),letrozole (FEMARA®) and aminoglutethimide, and other aromataseinhibitors include vorozole (RIVISOR®), megestrol acetate (MEGASE®),fadrozole, and 4(5)-imidazoles; lutenizing hormone-releasing hormoneagonists, including leuprolide (LUPRON® and ELIGARD®), goserelin,buserelin, and tripterelin; sex steroids, including progestines such asmegestrol acetate and medroxyprogesterone acetate, estrogens such asdiethylstilbestrol and premarin, and androgens/retinoids such asfluoxymesterone, all transretionic acid and fenretinide; onapristone;anti-progesterones; estrogen receptor down-regulators (ERDs);anti-androgens such as flutamide, nilutamide and bicalutamide; andpharmaceutically acceptable salts, acids or derivatives of any of theabove; as well as combinations of two or more of the above.

The term “prodrug” as used in this application refers to a precursor orderivative form of a pharmaceutically active substance that is lesscytotoxic to tumor cells compared to the parent drug and is capable ofbeing enzymatically activated or converted into the more active parentform. See, e.g., Wilman, “Prodrugs in Cancer Chemotherapy” BiochemicalSociety Transactions, 14, pp. 375-382, 615th Meeting Belfast (1986) andStella et al., “Prodrugs: A Chemical Approach to Targeted DrugDelivery,” Directed Drug Delivery, Borchardt et al., (ed.), pp. 247-267,Humana Press (1985). The prodrugs of this invention include, but are notlimited to, phosphate-containing prodrugs, thiophosphate-containingprodrugs, sulfate-containing prodrugs, peptide-containing prodrugs,D-amino acid-modified prodrugs, glycosylated prodrugs,β-lactam-containing prodrugs, optionally substitutedphenoxyacetamide-containing prodrugs or optionally substitutedphenylacetamide-containing prodrugs, 5-fluorocytosine and other5-fluorouridine prodrugs which can be converted into the more activecytotoxic free drug. Examples of cytotoxic drugs that can be derivatizedinto a prodrug form for use in this invention include, but are notlimited to, those chemotherapeutic agents described above.

A “growth inhibitory agent” when used herein refers to a compound orcomposition which inhibits growth of a cell (e.g., a cell whose growthis dependent upon PD-L1 expression either in vitro or in vivo). Examplesof growth inhibitory agents include agents that block cell cycleprogression (at a place other than S phase), such as agents that induceG1 arrest and M-phase arrest. Classical M-phase blockers include thevincas (vincristine and vinblastine), taxanes, and topoisomerase IIinhibitors such as doxorubicin, epirubicin, daunorubicin, etoposide, andbleomycin. Those agents that arrest G1 also spill over into S-phasearrest, for example, DNA alkylating agents such as tamoxifen,prednisone, dacarbazine, mechlorethamine, cisplatin, methotrexate,5-fluorouracil, and ara-C. Further information can be found in TheMolecular Basis of Cancer, Mendelsohn and Israel, eds., Chapter 1,entitled “Cell cycle regulation, oncogenes, and antineoplastic drugs” byMurakami et al. (WB Saunders: Philadelphia, 1995), especially p. 13. Thetaxanes (paclitaxel and docetaxel) are anticancer drugs both derivedfrom the yew tree. Docetaxel (TAXOTERE®, Rhone-Poulenc Rorer), derivedfrom the European yew, is a semisynthetic analogue of paclitaxel(TAXOL®, Bristol-Myers Squibb). Paclitaxel and docetaxel promote theassembly of microtubules from tubulin dimers and stabilize microtubulesby preventing depolymerization, which results in the inhibition ofmitosis in cells.

By “radiation therapy” is meant the use of directed gamma rays or betarays to induce sufficient damage to a cell so as to limit its ability tofunction normally or to destroy the cell altogether. It will beappreciated that there will be many ways known in the art to determinethe dosage and duration of treatment. Typical treatments are given as aone time administration and typical dosages range from 10 to 200 units(Grays) per day.

An “individual” or “subject” is a mammal. Mammals include, but are notlimited to, domesticated animals (e.g., cows, sheep, cats, dogs, andhorses), primates (e.g., humans and non-human primates such as monkeys),rabbits, and rodents (e.g., mice and rats). In certain embodiments, theindividual or subject is a human.

The term “concurrently” is used herein to refer to administration of twoor more therapeutic agents, where at least part of the administrationoverlaps in time. Accordingly, concurrent administration includes adosing regimen when the administration of one or more agent(s) continuesafter discontinuing the administration of one or more other agent(s).

By “reduce or inhibit” is meant the ability to cause an overall decreaseof 20%, 30%, 40%, 50%, 60%, 70%, 75%, 80%, 85%, 90%, 95%, or greater.Reduce or inhibit can refer to the symptoms of the disorder beingtreated, the presence or size of metastases, or the size of the primarytumor.

The term “package insert” is used to refer to instructions customarilyincluded in commercial packages of therapeutic products, that containinformation about the indications, usage, dosage, administration,combination therapy, contraindications and/or warnings concerning theuse of such therapeutic products.

An “article of manufacture” is any manufacture (e.g., a package orcontainer) or kit comprising at least one reagent, e.g., a medicamentfor treatment of a disease or disorder (e.g., cancer), or a probe forspecifically detecting a biomarker described herein. In certainembodiments, the manufacture or kit is promoted, distributed, or sold asa unit for performing the methods described herein.

A “target audience” is a group of people or an institution to whom or towhich a particular medicament is being promoted or intended to bepromoted, as by marketing or advertising, especially for particularuses, treatments, or indications, such as individuals, populations,readers of newspapers, medical literature, and magazines, television orinternet viewers, radio or internet listeners, physicians, drugcompanies, etc.

The phrase “based on” when used herein means that the information aboutone or more biomarkers is used to inform a treatment decision,information provided on a package insert, or marketing/promotionalguidance, etc.

As is understood by one skilled in the art, reference to “about” a valueor parameter herein includes (and describes) embodiments that aredirected to that value or parameter per se. For example, descriptionreferring to “about X” includes description of “X”.

It is understood that aspect and embodiments described herein include“consisting” and/or “consisting essentially of” aspects and embodiments.As used herein, the singular form “a”, “an”, and “the” includes pluralreferences unless indicated otherwise.

I. Methods and Uses

Provided herein are methods utilizing PD-L1 biomarkers. In particular,methods utilizing a PD-L1 axis binding antagonist and a PD-L1 biomarkerare provided.

Diagnostic Methods

Provided herein are methods for identifying an individual with a diseaseor disorder who is more likely to respond to treatment with a PD-L1 axisbinding antagonist, the method comprising: determining the presence of aPD-L1 biomarker in a sample from the individual, wherein the presence ofa PD-L1 biomarker in the sample indicates that the individual is morelikely to respond to treatment with the PD-L1 axis binding antagonist,and providing a recommendation that the individual will be more likelyto respond to treatment with a PD-L1 axis binding antagonist.

Further provided herein methods for predicting responsiveness of anindividual with a disease or disorder to treatment with a PD-L1 axisbinding antagonist, the method comprising: determining the presence of aPD-L1 biomarker in a sample from the individual, wherein the presence ofa PD-L1 biomarker in the sample indicates that the individual is morelikely to be responsive to treatment with the PD-L1 axis bindingantagonist, and providing a recommendation that the individual will havean increased likelihood of being responsive to treatment with a PD-L1axis binding antagonist.

Further provided herein are methods for determining likelihood that anindividual with a disease or disorder will exhibit benefit fromtreatment with a PD-L1 axis binding antagonist, the method comprising:determining the presence of a PD-L1 biomarker in a sample from theindividual, wherein the presence of a PD-L1 biomarker in the sampleindicates that the individual has an increased likelihood of benefitfrom treatment with the PD-L1 axis binding antagonist, and providing arecommendation that the individual will have an increased likelihood ofbenefit from treatment with a PD-L1 axis binding antagonist.

Further provided are methods for selecting a therapy for an individualwith a disease or disorder, the method comprising: determining thepresence of a PD-L1 biomarker in a sample from the individual, andproviding a recommendation that the therapy selected for the individualcomprise treatment with a PD-L1 axis binding antagonist based on thepresence of a PD-L1 biomarker in the sample.

In some embodiments, the methods further comprise administering aneffective amount of the PD-L1 axis binding antagonist to the individual.

In some embodiments, the PD-L1 biomarker is selected from the groupconsisting of PD-L1, PD-1, PD-L2 and any combinations thereof.

In some embodiments, the PD-L1 biomarker is an immune-related marker. Animmune-related marker refers to a marker that is expressed by immunecells, or by other cells (e.g. tumor cells, endothelial cells,fibroblasts or other stromal cells). If expressed by other than immunecells, the marker may be involved in regulation of immune cell biologyand function, such as activation, priming, antigen recognition andpresentation, cytokine and chemokine production, proliferation,migration, survival, antibody production and other. In some embodiments,the immune-related marker is a T-cell related marker. In someembodiments, the T-cell related marker is selected from the groupconsisting of CD8A, IFN-g, EOMES, Granzyme-A, CXCL9 and any combinationsthereof. In some embodiments, the immune-related marker is selected fromthe group consisting of CX3CL1, CD45RO, IDO1, Galectin 9, MIC-A, MIC-B,CTLA-4 and any combinations thereof.

In some embodiments, the presence of a PD-L1 biomarker indicates thatthe individual is likely to have increased clinical benefit when theindividual is treated with the PD-L1 axis binding antagonist. In someembodiments, the increased clinical benefit comprises a relativeincrease in one or more of the following: overall survival (OS),progression free survival (PFS), complete response (CR), partialresponse (PR) and combinations thereof.

In some embodiments, the PD-L1 biomarker is absent from the sample whenit comprises 0% of the sample. In some embodiments, the PD-L1 biomarkeris present in the sample when it comprises more than 0% of the sample.In some embodiments, the PD-L1 biomarker is present in at least 1% ofthe sample. In some embodiments, the PD-L1 biomarker is present in atleast 5% of the sample. In some embodiments, the PD-L1 biomarker ispresent in at least 10% of the sample.

In some embodiments, the PD-L1 biomarker is detected in the sample usinga method selected from the group consisting of FACS, Western blot,ELISA, immunoprecipitation, immunohistochemistry, immunofluorescence,radioimmunoassay, dot blotting, immunodetection methods, HPLC, surfaceplasmon resonance, optical spectroscopy, mass spectrometery, HPLC, qPCR,RT-qPCR, multiplex qPCR or RT-qPCR, RNA-seq, microarray analysis, SAGE,MassARRAY technique, and FISH, and combinations thereof. In someembodiments, the PD-L1 biomarker is detected in the sample by proteinexpression. In some embodiments, protein expression is determined byimmunohistochemistry (IHC). In some embodiments, PD-L1 biomarker isdetected using an anti-PD-L1 antibody.

In some embodiments, the PD-L1 biomarker is detected as a weak stainingintensity by IHC. In some embodiments, the PD-L1 biomarker is detectedas a moderate staining intensity by IHC. In some embodiments, the PD-L1biomarker is detected as a strong staining intensity by IHC.

In some embodiments, the PD-L1 biomarker is detected on tumor cells,tumor infiltrating immune cells or combinations thereof using proteinexpression analysis such as IHC analysis. Tumor infiltrating immunecells include, but is not limited to, intratumoral immune cells,peritumoral immune cells or any combinations thereof, other tumor stromacells (e.g. fibroblasts). Such tumor infiltrating immune cells can be Tlymphocytes (such as CD8+ T lymphocytes and/or CD4+ T lymphocytes), Blymphocytes, or other bone marrow-lineage cells including granulocytes(neutrophils, eosinophils, basophils), monocytes, macrophages, dendriticcells (i.e., interdigitating dendritic cells), histiocytes, and naturalkiller cells.

In some embodiments, the staining for the PD-L1 biomarker is detected asmembrane staining, cytoplasmic staining and combinations thereof. Inother embodiments, the absence of the PD-L1 biomarker is detected asabsent or no staining in the sample.

In some embodiments, the PD-L1 biomarker is detected in the sample bynucleic acid expression. In some embodiments, the nucleic acidexpression is determined using qPCR, rtPCR, RNA-seq, multiplex qPCR orRT-qPCR, microarray analysis, SAGE, MassARRAY technique, or FISH.

In some embodiments, the PD-L1 biomarker is detected on tumor cells,tumor infiltrating immune cells, stromal cells and combinations thereofusing nucleic acid expression such as qPCR analysis.

In some embodiments of any of the methods, assays and/or kits, the PD-L1axis binding antagonist is selected from the group consisting of a PD-L1binding antagonist and a PD-1 binding antagonist.

In some embodiments of any of the methods, assays and/or kits, the PD-L1axis binding antagonist is a PD-L1 binding antagonist. In someembodiments of any of the methods, assays and/or kits, the PD-L1 bindingantagonist inhibits the binding of PD-L1 to its ligand binding partners.In some embodiments of any of the methods, assays and/or kits, the PD-L1binding antagonist inhibits the binding of PD-L1 to PD-1. In someembodiments of any of the methods, assays and/or kits, the PD-L1 bindingantagonist inhibits the binding of PD-L1 to B7-1. In some embodiments ofany of the methods, assays and/or kits, the PD-L1 binding antagonistinhibits the binding of PD-L1 to both PD-1 and B7-1.

In some embodiments of any of the methods, assays and/or kits, the PD-L1binding antagonist is an antibody. In some embodiments of any of themethods, assays and/or kits, the antibody is a monoclonal antibody. Insome embodiments of any of the methods, assays and/or kits, the antibodyis a human, humanized or chimeric antibody.

In some embodiments of any of the methods, assays and/or kits, the PD-L1axis binding antagonist is a PD-1 binding antagonist. In someembodiments of any of the methods, assays and/or kits, the PD-1 bindingantagonist inhibits the binding of PD-1 to its ligand binding partners.In some embodiments of any of the methods, assays and/or kits, the PD-1binding antagonist inhibits the binding of PD-1 to PD-L1. In someembodiments of any of the methods, assays and/or kits, the PD-1 bindingantagonist inhibits the binding of PD-1 to PD-L2. In some embodiments ofany of the methods, assays and/or kits, the PD-1 binding antagonistinhibits the binding of PD-1 to both PD-L1 and PD-L2.

In some embodiments, the sample obtained from the individual is selectedfrom the group consisting of tissue, whole blood, plasma, serum andcombinations thereof. In some embodiments, the sample is a tissuesample. In some embodiments, the sample is a tumor tissue sample. Insome embodiments, the tumor tissue sample comprises tumor cells, tumorinfiltrating immune cells, stromal cells or any combinations thereof.

In some embodiments, the sample is obtained prior to treatment with aPD-L1 axis binding antagonist. In some embodiments, the tissue sample isformalin fixed and paraffin embedded, archival, fresh or frozen

In some embodiments, the sample is whole blood. In some embodiments, thewhole blood comprises immune cells, circulating tumor cells and anycombinations thereof.

In some embodiments, the disease or disorder is a proliferative diseaseor disorder. In some embodiments, the disease or disorder is animmune-related disease or disorder. In some embodiments, the disease ordisorder is cancer. In some embodiments, the cancer is non-small celllung cancer, small cell lung cancer, renal cell cancer, colorectalcancer, ovarian cancer, breast cancer, pancreatic cancer, gastriccarcinoma, bladder cancer, esophageal cancer, mesothelioma, melanoma,head and neck cancer, thyroid cancer, sarcoma, prostate cancer,glioblastoma, cervical cancer, thymic carcinoma, leukemia, lymphomas,myelomas, mycoses fungoids, merkel cell cancer, and other hematologicmalignancies.

Presence and/or expression levels/amount of a biomarker (e.g., PD-L1)can be determined qualitatively and/or quantitatively based on anysuitable criterion known in the art, including but not limited to DNA,mRNA, cDNA, proteins, protein fragments and/or gene copy number. Incertain embodiments, presence and/or expression levels/amount of abiomarker in a first sample is increased or elevated as compared topresence/absence and/or expression levels/amount in a second sample. Incertain embodiments, presence/absence and/or expression levels/amount ofa biomarker in a first sample is decreased or reduced as compared topresence and/or expression levels/amount in a second sample. In certainembodiments, the second sample is a reference sample, reference cell,reference tissue, control sample, control cell, or control tissue.Additional disclosures for determining presence/absence and/orexpression levels/amount of a gene are described herein.

In some embodiments of any of the methods, elevated expression refers toan overall increase of about any of 10%, 20%, 30%, 40%, 50%, 60%, 70%,80%, 90%, 95%, 96%, 97%, 98%, 99% or greater, in the level of biomarker(e.g., protein or nucleic acid (e.g., gene or mRNA)), detected bystandard art known methods such as those described herein, as comparedto a reference sample, reference cell, reference tissue, control sample,control cell, or control tissue. In certain embodiments, the elevatedexpression refers to the increase in expression level/amount of abiomarker in the sample wherein the increase is at least about any of1.5×, 1.75×, 2×, 3×, 4×, 5×, 6×, 7×, 8×, 9×, 10×, 25×, 50×, 75×, or 100×the expression level/amount of the respective biomarker in a referencesample, reference cell, reference tissue, control sample, control cell,or control tissue. In some embodiments, elevated expression refers to anoverall increase of greater than about 1.5 fold, about 1.75 fold, about2 fold, about 2.25 fold, about 2.5 fold, about 2.75 fold, about 3.0fold, or about 3.25 fold as compared to a reference sample, referencecell, reference tissue, control sample, control cell, control tissue, orinternal control (e.g., housekeeping gene).

In some embodiments of any of the methods, reduced expression refers toan overall reduction of about any of 10%, 20%, 30%, 40%, 50%, 60%, 70%,80%, 90%, 95%, 96%, 97%, 98%, 99% or greater, in the level of biomarker(e.g., protein or nucleic acid (e.g., gene or mRNA)), detected bystandard art known methods such as those described herein, as comparedto a reference sample, reference cell, reference tissue, control sample,control cell, or control tissue. In certain embodiments, reducedexpression refers to the decrease in expression level/amount of abiomarker in the sample wherein the decrease is at least about any of0.9×, 0.8×, 0.7×, 0.6×, 0.5×, 0.4×, 0.3×, 0.2×, 0.1×, 0.05×, or 0.01×the expression level/amount of the respective biomarker in a referencesample, reference cell, reference tissue, control sample, control cell,or control tissue.

Presence and/or expression level/amount of various biomarkers in asample can be analyzed by a number of methodologies, many of which areknown in the art and understood by the skilled artisan, including, butnot limited to, immunohistochemistry (“IHC”), Western blot analysis,immunoprecipitation, molecular binding assays, ELISA, ELIFA,fluorescence activated cell sorting (“FACS”), MassARRAY, proteomics,quantitative blood based assays (as for example Serum ELISA),biochemical enzymatic activity assays, in situ hybridization, Southernanalysis, Northern analysis, whole genome sequencing, polymerase chainreaction (“PCR”) including quantitative real time PCR (“qRT-PCR”) andother amplification type detection methods, such as, for example,branched DNA, SISBA, TMA and the like), RNA-Seq, FISH, microarrayanalysis, gene expression profiling, and/or serial analysis of geneexpression (“SAGE”), as well as any one of the wide variety of assaysthat can be performed by protein, gene, and/or tissue array analysis.Typical protocols for evaluating the status of genes and gene productsare found, for example in Ausubel et al., eds., 1995, Current ProtocolsIn Molecular Biology, Units 2 (Northern Blotting), 4 (SouthernBlotting), 15 (Immunoblotting) and 18 (PCR Analysis). Multiplexedimmunoassays such as those available from Rules Based Medicine or MesoScale Discovery (“MSD”) may also be used.

In some embodiments, presence and/or expression level/amount of abiomarker is determined using a method comprising: (a) performing geneexpression profiling, PCR (such as rtPCR or qRT-PCR), RNA-seq,microarray analysis, SAGE, MassARRAY technique, or FISH on a sample(such as a subject cancer sample); and b) determining presence and/orexpression level/amount of a biomarker in the sample. In someembodiments, the microarray method comprises the use of a microarraychip having one or more nucleic acid molecules that can hybridize understringent conditions to a nucleic acid molecule encoding a genementioned above or having one or more polypeptides (such as peptides orantibodies) that can bind to one or more of the proteins encoded by thegenes mentioned above. In one embodiment, the PCR method is qRT-PCR. Inone embodiment, the PCR method is multiplex-PCR. In some embodiments,gene expression is measured by microarray. In some embodiments, geneexpression is measured by qRT-PCR. In some embodiments, expression ismeasured by multiplex-PCR.

Methods for the evaluation of mRNAs in cells are well known and include,for example, hybridization assays using complementary DNA probes (suchas in situ hybridization using labeled riboprobes specific for the oneor more genes, Northern blot and related techniques) and various nucleicacid amplification assays (such as RT-PCR using complementary primersspecific for one or more of the genes, and other amplification typedetection methods, such as, for example, branched DNA, SISBA, TMA andthe like).

Samples from mammals can be conveniently assayed for mRNAs usingNorthern, dot blot or PCR analysis. In addition, such methods caninclude one or more steps that allow one to determine the levels oftarget mRNA in a biological sample (e.g., by simultaneously examiningthe levels a comparative control mRNA sequence of a “housekeeping” genesuch as an actin family member). Optionally, the sequence of theamplified target cDNA can be determined.

Optional methods include protocols which examine or detect mRNAs, suchas target mRNAs, in a tissue or cell sample by microarray technologies.Using nucleic acid microarrays, test and control mRNA samples from testand control tissue samples are reverse transcribed and labeled togenerate cDNA probes. The probes are then hybridized to an array ofnucleic acids immobilized on a solid support. The array is configuredsuch that the sequence and position of each member of the array isknown. For example, a selection of genes whose expression correlateswith increased or reduced clinical benefit of anti-angiogenic therapymay be arrayed on a solid support. Hybridization of a labeled probe witha particular array member indicates that the sample from which the probewas derived expresses that gene.

According to some embodiments, presence and/or expression level/amountis measured by observing protein expression levels of an aforementionedgene. In certain embodiments, the method comprises contacting thebiological sample with antibodies to a biomarker (e.g., anti-PD-L1antibodies) described herein under conditions permissive for binding ofthe biomarker, and detecting whether a complex is formed between theantibodies and biomarker. Such method may be an in vitro or in vivomethod. In one embodiment, an antibody is used to select subjectseligible for therapy with PD-L1 axis binding antagonist e.g., abiomarker for selection of individuals.

In certain embodiments, the presence and/or expression level/amount ofbiomarker proteins in a sample is examined using IHC and stainingprotocols. IHC staining of tissue sections has been shown to be areliable method of determining or detecting presence of proteins in asample. In some embodiments of any of the methods, assays and/or kits,the PD-L1 biomarker is PD-L1. In some embodiments, PD-L1 is detected byimmunohistochemistry. In some embodiments, elevated expression of aPD-L1 biomarker in a sample from an individual is elevated proteinexpression and, in further embodiments, is determined using IHC. In oneembodiment, expression level of biomarker is determined using a methodcomprising: (a) performing IHC analysis of a sample (such as a subjectcancer sample) with an antibody; and b) determining expression level ofa biomarker in the sample. In some embodiments, IHC staining intensityis determined relative to a reference. In some embodiments, thereference is a reference value. In some embodiments, the reference is areference sample (e.g., control cell line staining sample or tissuesample from non-cancerous patient).

IHC may be performed in combination with additional techniques such asmorphological staining and/or fluorescence in-situ hybridization. Twogeneral methods of IHC are available; direct and indirect assays.According to the first assay, binding of antibody to the target antigenis determined directly. This direct assay uses a labeled reagent, suchas a fluorescent tag or an enzyme-labeled primary antibody, which can bevisualized without further antibody interaction. In a typical indirectassay, unconjugated primary antibody binds to the antigen and then alabeled secondary antibody binds to the primary antibody. Where thesecondary antibody is conjugated to an enzymatic label, a chromogenic orfluorogenic substrate is added to provide visualization of the antigen.Signal amplification occurs because several secondary antibodies mayreact with different epitopes on the primary antibody.

The primary and/or secondary antibody used for IHC typically will belabeled with a detectable moiety. Numerous labels are available whichcan be generally grouped into the following categories: (a)Radioisotopes, such as ³⁵S, ¹⁴C, ¹²⁵I, ³H and ¹³¹I; (b) colloidal goldparticles; (c) fluorescent labels including, but are not limited to,rare earth chelates (europium chelates), Texas Red, rhodamine,fluorescein, dansyl, Lissamine, umbelliferone, phycoerytherin,phycocyanin, or commercially available fluorophores such SPECTRUMORANGE7 and SPECTRUM GREEN7 and/or derivatives of any one or more of theabove; (d) various enzyme-substrate labels are available and U.S. Pat.No. 4,275,149 provides a review of some of these. Examples of enzymaticlabels include luciferases (e.g., firefly luciferase and bacterialluciferase; U.S. Pat. No. 4,737,456), luciferin,2,3-dihydrophthalazinediones, malate dehydrogenase, urease, peroxidasesuch as horseradish peroxidase (HRPO), alkaline phosphatase,β-galactosidase, glucoamylase, lysozyme, saccharide oxidases (e.g.,glucose oxidase, galactose oxidase, and glucose-6-phosphatedehydrogenase), heterocyclic oxidases (such as uricase and xanthineoxidase), lactoperoxidase, microperoxidase, and the like.

Examples of enzyme-substrate combinations include, for example,horseradish peroxidase (HRPO) with hydrogen peroxidase as a substrate;alkaline phosphatase (AP) with para-Nitrophenyl phosphate as chromogenicsubstrate; and β-D-galactosidase (β-D-Gal) with a chromogenic substrate(e.g., p-nitrophenyl-β-D-galactosidase) or fluorogenic substrate (e.g.,4-methylumbelliferyl-β-D-galactosidase). For a general review of these,see U.S. Pat. Nos. 4,275,149 and 4,318,980.

In some embodiments of any of the methods, PD-L1 is detected byimmunohistochemistry using an anti-PD-L1 diagnostic antibody (i.e.,primary antibody). In some embodiments, the PD-L1 diagnostic antibodyspecifically binds human PD-L1. In some embodiments, the PD-L1diagnostic antibody is a nonhuman antibody. In some embodiments, thePD-L1 diagnostic antibody is a rat, mouse, or rabbit antibody. In someembodiments, the PD-L1 diagnostic antibody is a monoclonal antibody. Insome embodiments, the PD-L1 diagnostic antibody is directly labeled.

Specimens thus prepared may be mounted and coverslipped. Slideevaluation is then determined, e.g., using a microscope, and stainingintensity criteria, routinely used in the art, may be employed. In oneembodiment, it is understood that when cells and/or tissue from a tumoris examined using IHC, staining is generally determined or assessed intumor cell and/or tissue (as opposed to stromal or surrounding tissuethat may be present in the sample). In some embodiments, it isunderstood that when cells and/or tissue from a tumor is examined usingIHC, staining includes determining or assessing in tumor infiltratingimmune cells, including intratumoral or peritumoral immune cells. Insome embodiments, the presence of a PD-L1 biomarker is detected by IHCin >0% of the sample, in at least 1% of the sample, in at least 5% ofthe sample, in at least 10% of the sample.

In some embodiments of any of the methods, assays, and/or kits, thepresence of a PD-L1 biomarker is detected by IHC with PD-L1 staining ofany intensity. In some embodiments, the PD-L1 biomarker is detected byIHC as a weak staining intensity. In some embodiments, the PD-L1biomarker is detected by IHC as a moderate staining intensity. In someembodiments, the PD-L1 biomarker is detected by IHC as a strong stainingintensity.

In some embodiments, the PD-L1 biomarker is detected by IHC in tumorcells, tumor infiltrating immune cells and combinations thereof.

Anti-PD-L1 antibodies suitable for use in IHC are well known in the art.One of ordinary skill understands that additional suitable anti-PD-L1antibodies may be identified and characterized by comparing withanti-PD-L1 antibodies using the IHC protocol disclosed herein, forexample.

Positive tissue controls are exemplified using placenta and tonsiltissues (strong PD-L1 staining intensity); HEK-293 cells transfectedwith recombinant human PD-L1 (varying degrees of PD-L1 stainingintensity from weak, moderate and strong intensity). The following maybe referred to for exemplary PD-L1 IHC criteria.

PD-L1 Status Staining criteria Negative 0% membrane staining orcytoplasmic staining or combinations of both at ANY staining intensityPositive >0% membrane staining or cytoplasmic staining or combinationsof both at ANY staining intensity ≥1% membrane staining or cytoplasmicstaining or combinations of both at ANY staining intensity ≥5% membranestaining or cytoplasmic staining or combinations of both at ANY stainingintensity ≥10% membrane staining or cytoplasmic staining or combinationsof both at ANY staining intensity

In some embodiments, the criteria for PD-L1 IHC diagnostic assessment isprovided as follows:

IHC PD-L1 Diagnostic Assessment Scores Absence of any discernible PD-L1staining IHC 0 OR Presence of discernible PD-L1 staining of anyintensity in tumor-infiltrating immune cells covering <1% of tumor areaoccupied by tumor cells, associated intratumoral, and contiguousperi-tumoral desmoplastic stroma Presence of discernible PD-L1 stainingof any intensity in IHC 1 tumor-infiltrating immune cells coveringbetween ≥1% to <5% of tumor area occupied by tumor cells, associatedintratumoral, and contiguous peri-tumoral desmoplastic stroma Presenceof discernible PD-L1 staining of any intensity in tumor IHC 2infiltrating immune cells covering between ≥5% to <10% of tumor areaoccupied by tumor cells, associated intratumoral, and contiguousperi-tumoral desmoplastic stroma Presence of discernible PD-L1 stainingof any intensity in tumor IHC 3 infiltrating immune cells covering ≥10%of tumor area occupied by tumor cells, associated intratumoral, andcontiguous peri- tumoral desmoplastic stroma

In alternative methods, the sample may be contacted with an antibodyspecific for said biomarker under conditions sufficient for anantibody-biomarker complex to form, and then detecting said complex. Thepresence of the biomarker may be detected in a number of ways, such asby Western blotting and ELISA procedures for assaying a wide variety oftissues and samples, including plasma or serum. A wide range ofimmunoassay techniques using such an assay format are available, see,e.g., U.S. Pat. Nos. 4,016,043, 4,424,279 and 4,018,653. These includeboth single-site and two-site or “sandwich” assays of thenon-competitive types, as well as in the traditional competitive bindingassays. These assays also include direct binding of a labeled antibodyto a target biomarker.

Presence and/or expression level/amount of a selected biomarker in atissue or cell sample may also be examined by way of functional oractivity-based assays. For instance, if the biomarker is an enzyme, onemay conduct assays known in the art to determine or detect the presenceof the given enzymatic activity in the tissue or cell sample.

In certain embodiments, the samples are normalized for both differencesin the amount of the biomarker assayed and variability in the quality ofthe samples used, and variability between assay runs. Such normalizationmay be accomplished by detecting and incorporating the expression ofcertain normalizing biomarkers, including well known housekeeping genes.Alternatively, normalization can be based on the mean or median signalof all of the assayed genes or a large subset thereof (globalnormalization approach). On a gene-by-gene basis, measured normalizedamount of a subject tumor mRNA or protein is compared to the amountfound in a reference set. Normalized expression levels for each mRNA orprotein per tested tumor per subject can be expressed as a percentage ofthe expression level measured in the reference set. The presence and/orexpression level/amount measured in a particular subject sample to beanalyzed will fall at some percentile within this range, which can bedetermined by methods well known in the art.

In one embodiment, the sample is a clinical sample. In anotherembodiment, the sample is used in a diagnostic assay. In someembodiments, the sample is obtained from a primary or metastatic tumor.Tissue biopsy is often used to obtain a representative piece of tumortissue. Alternatively, tumor cells can be obtained indirectly in theform of tissues or fluids that are known or thought to contain the tumorcells of interest. For instance, samples of lung cancer lesions may beobtained by resection, bronchoscopy, fine needle aspiration, bronchialbrushings, or from sputum, pleural fluid or blood. Genes or geneproducts can be detected from cancer or tumor tissue or from other bodysamples such as urine, sputum, serum or plasma. The same techniquesdiscussed above for detection of target genes or gene products incancerous samples can be applied to other body samples. Cancer cells maybe sloughed off from cancer lesions and appear in such body samples. Byscreening such body samples, a simple early diagnosis can be achievedfor these cancers. In addition, the progress of therapy can be monitoredmore easily by testing such body samples for target genes or geneproducts.

In certain embodiments, a reference sample, reference cell, referencetissue, control sample, control cell, or control tissue is a singlesample or combined multiple samples from the same subject or individualthat are obtained at one or more different time points than when thetest sample is obtained. For example, a reference sample, referencecell, reference tissue, control sample, control cell, or control tissueis obtained at an earlier time point from the same subject or individualthan when the test sample is obtained. Such reference sample, referencecell, reference tissue, control sample, control cell, or control tissuemay be useful if the reference sample is obtained during initialdiagnosis of cancer and the test sample is later obtained when thecancer becomes metastatic.

In certain embodiments, a reference sample, reference cell, referencetissue, control sample, control cell, or control tissue is a combinedmultiple samples from one or more healthy individuals who are not thesubject or individual. In certain embodiments, a reference sample,reference cell, reference tissue, control sample, control cell, orcontrol tissue is a combined multiple samples from one or moreindividuals with a disease or disorder (e.g., cancer) who are not thesubject or individual. In certain embodiments, a reference sample,reference cell, reference tissue, control sample, control cell, orcontrol tissue is pooled RNA samples from normal tissues or pooledplasma or serum samples from one or more individuals who are not thesubject or individual. In certain embodiments, a reference sample,reference cell, reference tissue, control sample, control cell, orcontrol tissue is pooled RNA samples from tumor tissues or pooled plasmaor serum samples from one or more individuals with a disease or disorder(e.g., cancer) who are not the subject or individual.

In some embodiments, the sample is a tissue sample from the individual.In some embodiments, the tissue sample is a tumor tissue sample (e.g.,biopsy tissue). In some embodiments, the tissue sample is lung tissue.In some embodiments, the tissue sample is renal tissue. In someembodiments, the tissue sample is skin tissue. In some embodiments, thetissue sample is pancreatic tissue. In some embodiments, the tissuesample is gastric tissue. In some embodiments, the tissue sample isbladder tissue. In some embodiments, the tissue sample is esophagealtissue. In some embodiments, the tissue sample is mesothelial tissue. Insome embodiments, the tissue sample is breast tissue. In someembodiments, the tissue sample is thyroid tissue. In some embodiments,the tissue sample is colorectal tissue. In some embodiments, the tissuesample is head and neck tissue. In some embodiments, the tissue sampleis osteosarcoma tissue. In some embodiments, the tissue sample isprostate tissue. In some embodiments, the tissue sample is ovariantissue, HCC (liver), blood cells, lymph nodes, bone/bone marrow.

In some embodiments of any of the methods, the disease or disorder is atumor. In some embodiments, the tumor is a malignant cancerous tumor(i.e., cancer). In some embodiments, the tumor and/or cancer is a solidtumor or a non-solid or soft tissue tumor. Examples of soft tissuetumors include leukemia (e.g., chronic myelogenous leukemia, acutemyelogenous leukemia, adult acute lymphoblastic leukemia, acutemyelogenous leukemia, mature B-cell acute lymphoblastic leukemia,chronic lymphocytic leukemia, polymphocytic leukemia, or hairy cellleukemia) or lymphoma (e.g., non-Hodgkin's lymphoma, cutaneous T-celllymphoma, or Hodgkin's disease). A solid tumor includes any cancer ofbody tissues other than blood, bone marrow, or the lymphatic system.Solid tumors can be further divided into those of epithelial cell originand those of non-epithelial cell origin. Examples of epithelial cellsolid tumors include tumors of the gastrointestinal tract, colon,colorectal (e.g., basaloid colorectal carcinoma), breast, prostate,lung, kidney, liver, pancreas, ovary (e.g., endometrioid ovariancarcinoma), head and neck, oral cavity, stomach, duodenum, smallintestine, large intestine, anus, gall bladder, labium, nasopharynx,skin, uterus, male genital organ, urinary organs (e.g., urotheliumcarcinoma, dysplastic urothelium carcinoma, transitional cellcarcinoma), bladder, and skin. Solid tumors of non-epithelial origininclude sarcomas, brain tumors, and bone tumors. In some embodiments,the cancer isnon-small cell lung cancer (NSCLC). In some embodiments,the cancer is second-line or third-line locally advanced or metastaticnon-small cell lung cancer. In some embodiments, the cancer isadenocarcinoma. In some embodiments, the cancer is squamous cellcarcinoma.

In some embodiments, the PD-L1 biomarker is detected in the sample usinga method selected from the group consisting of FACS, Western blot,ELISA, immunoprecipitation, immunohistochemistry, immunofluorescence,radioimmunoassay, dot blotting, immunodetection methods, HPLC, surfaceplasmon resonance, optical spectroscopy, mass spectrometery, HPLC, qPCR,RT-qPCR, multiplex qPCR or RT-qPCR, RNA-seq, microarray analysis, SAGE,MassARRAY technique, and FISH, and combinations thereof. In someembodiments, the PD-L1 biomarker is detected using FACS analysis. Insome embodiments, the PD-L1 biomarker is PD-L1. In some embodiments, thePD-L1 expression is detected in blood samples. In some embodiments, thePD-L1 expression is detected on circulating immune cells in bloodsamples. In some embodiments, the circulating immune cell is a CD3+/CD8+T cell. In some embodiments, prior to analysis, the immune cells areisolated from the blood samples. Any suitable method to isolate/enrichsuch population of cells may be used including, but not limited to, cellsorting. In some embodiments, the PD-L1 expression is elevated insamples from individuals that respond to treatment with an inhibitor ofthe PD-L1/PD-1 axis pathway, such as an anti-PD-L1 antibody. In someembodiments, the PD-L1 expression is elevated on the circulating immunecells, such as the CD3+/CD8+ T cells, in blood samples.

Therapeutic Methods

Provided are methods for treating a disease or disorder in anindividual, the method comprising: determining the presence of a PD-L1biomarker in a sample from the individual, and administering aneffective amount of a PD-L1 axis binding antagonist to the individual.

Further provided herein are treating a disease or disorder in anindividual comprising administering to the individual an effectiveamount of a PD-L1 axis binding antagonist, wherein treatment is basedupon the presence of a PD-L1 biomarker in a sample from the individual.

In some embodiments, the PD-L1 biomarker is selected from the groupconsisting of PD-L1, PD-1, PD-L2 and any combinations thereof.

In some embodiments, the PD-L1 biomarker is an immune-related marker. Animmune-related marker refers to a marker that is expressed by immunecells, or by other cells (e.g., tumor cells, endothelial cells,fibroblasts or other stromal cells). If expressed by other than immunecells, the marker may be involved in regulation of immune cell biologyand function, such as activation, priming, antigen recognition andpresentation, cytokine and chemokine production, proliferation,migration, survival, antibody production and other. In some embodiments,the immune-related marker is a T-cell related marker. In someembodiments, the T-cell related marker is selected from the groupconsisting of CD8A, IFN-g, EOMES, Granzyme-A, CXCL9 and any combinationthereof. In some embodiments, the immune-related marker is selected fromthe group consisting of CX3CL1, CD45RO, IDO1, Galectin 9, MIC-A, MIC-B,CTLA-4 and any combinations thereof.

In some embodiments, the presence of a PD-L1 biomarker indicates thatthe individual is likely to have increased clinical benefit when theindividual is treated with the PD-L1 axis binding antagonist. In someembodiments, the increased clinical benefit comprises a relativeincrease in one or more of the following: overall survival (OS),progression free survival (PFS), complete response (CR), partialresponse (PR) and combinations thereof.

In some embodiments, the PD-L1 biomarker is absent from the sample whenit comprises 0% of the sample. In some embodiments, the PD-L1 biomarkeris present in the sample when it comprises more than 0% of the sample.In some embodiments, the PD-L1 biomarker is present in at least 1% ofthe sample. In some embodiments, the PD-L1 biomarker is present in atleast 5% of the sample. In some embodiments, the PD-L1 biomarker ispresent in at least 10% of the sample.

In some embodiments, the PD-L1 biomarker is detected in the sample usinga method selected from the group consisting of FACS, Western blot,ELISA, immunoprecipitation, immunohistochemistry, immunofluorescence,radioimmunoassay, dot blotting, immunodetection methods, HPLC, surfaceplasmon resonance, optical spectroscopy, mass spectrometery, HPLC, qPCR,RT-qPCR, multiplex qPCR or RT-qPCR, RNA-seq, microarray analysis, SAGE,MassARRAY technique, and FISH, and combinations thereof.

In some embodiments, the PD-L1 biomarker is detected in the sample byprotein expression. In some embodiments, protein expression isdetermined by immunohistochemistry (IHC). In some embodiments, PD-L1biomarker is detected using an anti-PD-L1 antibody.

In some embodiments, the PD-L1 biomarker is detected as a weak stainingintensity by IHC. In some embodiments, the PD-L1 biomarker is detectedas a moderate staining intensity by IHC. In some embodiments, the PD-L1biomarker is detected as a strong staining intensity by IHC.

In some embodiments, the PD-L1 biomarker is detected on tumor cells,tumor infiltrating immune cells or combinations thereof using proteinexpression analysis such as IHC analysis. Tumor infiltrating immunecells include, but is not limited to, intratumoral immune cells,peritumoral immune cells or any combinations thereof, other tumor stromacells (e.g. fibroblasts). Such tumor infiltrating immune cells can be Tlymphocytes (such as CD8+ T lymphocytes and/or CD4+ T lymphocytes), Blymphocytes, or other bone marrow-lineage cells including granulocytes(neutrophils, eosinophils, basophils), monocytes, macrophages, dendriticcells (i.e., interdigitating dendritic cells), histiocytes, and naturalkiller cells.

In some embodiments, the staining for the PD-L1 biomarker is detected asmembrane staining, cytoplasmic staining and combinations thereof. Inother embodiments, the absence of the PD-L1 biomarker is detected asabsent or no staining in the sample.

In some embodiments, the PD-L1 biomarker is detected in the sample bynucleic acid expression. In some embodiments, the nucleic acidexpression is determined using qPCR, rtPCR, RNA-seq, multiplex qPCR orRT-qPCR, microarray analysis, SAGE, MassARRAY technique, or FISH.

In some embodiments, the PD-L1 biomarker is detected on tumor cells,tumor infiltrating immune cells, stromal cells and combinations thereofusing nucleic acid expression such as qPCR analysis.

In some embodiments of any of the methods, assays and/or kits, the PD-L1axis binding antagonist is selected from the group consisting of a PD-L1binding antagonist and a PD-1 binding antagonist.

In some embodiments of any of the methods, assays and/or kits, the PD-L1axis binding antagonist is a PD-L1 binding antagonist. In someembodiments of any of the methods, assays and/or kits, the PD-L1 bindingantagonist inhibits the binding of PD-L1 to its ligand binding partners.In some embodiments of any of the methods, assays and/or kits, the PD-L1binding antagonist inhibits the binding of PD-L1 to PD-1. In someembodiments of any of the methods, assays and/or kits, the PD-L1 bindingantagonist inhibits the binding of PD-L1 to B7-1. In some embodiments ofany of the methods, assays and/or kits, the PD-L1 binding antagonistinhibits the binding of PD-L1 to both PD-1 and B7-1.

In some embodiments of any of the methods, assays and/or kits, the PD-L1binding antagonist is an antibody. In some embodiments of any of themethods, assays and/or kits, the antibody is a monoclonal antibody. Insome embodiments of any of the methods, assays and/or kits, the antibodyis a human, humanized or chimeric antibody.

In some embodiments of any of the methods, assays and/or kits, the PD-L1axis binding antagonist is a PD-1 binding antagonist. In someembodiments of any of the methods, assays and/or kits, the PD-1 bindingantagonist inhibits the binding of PD-1 to its ligand binding partners.In some embodiments of any of the methods, assays and/or kits, the PD-1binding antagonist inhibits the binding of PD-1 to PD-L1. In someembodiments of any of the methods, assays and/or kits, the PD-1 bindingantagonist inhibits the binding of PD-1 to PD-L2. In some embodiments ofany of the methods, assays and/or kits, the PD-1 binding antagonistinhibits the binding of PD-1 to both PD-L1 and PD-L2.

Examples of anti-PD-L1 antibodies useful for the methods of thisinvention, and methods for making thereof are described in PCT patentapplication WO 2010/077634 A1, which are incorporated herein byreference.

In some embodiments, the anti-PD-L1 antibody is capable of inhibitingbinding between PD-L1 and PD-1 and/or between PD-L1 and B7-1. In someembodiments, the anti-PD-L1 antibody is a monoclonal antibody. In someembodiments, the anti-PD-L1 antibody is an antibody fragment selectedfrom the group consisting of Fab, Fab′-SH, Fv, scFv, and (Fab′)2fragments. In some embodiments, the anti-PD-L1 antibody is a humanizedantibody. In some embodiments, the anti-PD-L1 antibody is a humanantibody.

In one embodiment, the anti-PD-L1 antibody contains a heavy chainvariable region polypeptide comprising an HVR-H1, HVR-H2 and HVR-H3sequence, wherein:

(a) (SEQ ID NO: 1) the HVR-H1 sequence is GFTFSX1SWIH; (b)(SEQ ID NO: 2) the HVR-H2 sequence is AWIX2PYGGSX3YYADSVKG; (c)(SEQ ID NO: 3) the HVR-H3 sequence is RHWPGGFDY;

further wherein: X1 is D or G; X2 is S or L; X3 is T or S.

In one specific aspect, X1 is D; X2 is S and X3 is T. In another aspect,the polypeptide further comprises variable region heavy chain frameworksequences juxtaposed between the HVRs according to the formula:(HC-FR1)-(HVR-H1)-(HC-FR2)-(HVR-H2)-(HC-FR3)-(HVR-H3)-(HC-FR4). In yetanother aspect, the framework sequences are derived from human consensusframework sequences. In a further aspect, the framework sequences are VHsubgroup III consensus framework. In a still further aspect, at leastone of the framework sequences is the following:

(SEQ ID NO: 4) HC-FR1 is EVQLVESGGGLVQPGGSLRLSCAAS (SEQ ID NO: 5)HC-FR2 is WVRQAPGKGLEWV (SEQ ID NO: 6)HC-FR3 is RFTISADTSKNTAYLQMNSLRAEDTAVYYCAR (SEQ ID NO: 7)HC-FR4 is WGQGTLVTVSA.

In a still further aspect, the heavy chain polypeptide is furthercombined with a variable region light chain comprising an HVR-L1, HVR-L2and HVR-L3, wherein:

(a) (SEQ ID NO: 8) the HVR-L1 sequence is RASQX4X5X6TX7X8A; (b)(SEQ ID NO: 9) the HVR-L2 sequence is SASX9LX10S,; (c) (SEQ ID NO: 10)the HVR-L3 sequence is QQX11X12X13X14PX15T;

further wherein: X4 is D or V; X5 is V or I; X6 is S or N; X7 is A or F;X8 is V or L; X9 is F or T; X10 is Y or A; X11 is Y, G, F, or S; X12 isL, Y, F or W; X13 is Y, N, A, T, G, F or I; X14 is H, V, P, T or I; X15is A, W, R, P or T.

In a still further aspect, X4 is D; X5 is V; X6 is S; X7 is A; X8 is V;X9 is F; X10 is Y; X11 is Y; X12 is L; X13 is Y; X14 is H; X15 is A. Ina still further aspect, the light chain further comprises variableregion light chain framework sequences juxtaposed between the HVRsaccording to the formula:(LC-FR1)-(HVR-L1)-(LC-FR2)-(HVR-L2)-(LC-FR3)-(HVR-L3)-(LC-FR4). In astill further aspect, the framework sequences are derived from humanconsensus framework sequences. In a still further aspect, the frameworksequences are VL kappa I consensus framework. In a still further aspect,at least one of the framework sequence is the following:

(SEQ ID NO: 11) LC-FR1 is DIQMTQSPSSLSASVGDRVTITC (SEQ ID NO: 12)LC-FR2 is WYQQKPGKAPKLLIY (SEQ ID NO: 13)LC-FR3 is GVPSRFSGSGSGTDFTLTISSLQPEDFATYYC (SEQ ID NO: 14)LC-FR4 is FGQGTKVEIKR.

In another embodiment, provided is an isolated anti-PD-L1 antibody orantigen binding fragment comprising a heavy chain and a light chainvariable region sequence, wherein:

(a) the heavy chain comprises and HVR-H1, HVR-H2 and HVR-H3, whereinfurther:

(i) (SEQ ID NO: 1) the HVR-H1 sequence is GFTFSX1SWIH; (ii)(SEQ ID NO: 2) the HVR-H2 sequence is AWIX2PYGGSX3YYADSVKG (iii)(SEQ ID NO: 3) the HVR-H3 sequence is RHWPGGFDY, and

(b) the light chain comprises and HVR-L1, HVR-L2 and HVR-L3, whereinfurther:

(i) (SEQ ID NOs: 8) the HVR-L1 sequence is RASQX4X5X6TX7X8A (ii)(SEQ ID NOs: 9) the HVR-L2 sequence is SASX9LX10S; and (iii)(SEQ ID NOs: 10) the HVR-L3 sequence is QQX11X12X13X14PX15T;

Further wherein: X1 is D or G; X2 is S or L; X3 is T or S; X4 is D or V;X5 is V or I; X6 is S or N; X7 is A or F; X8 is V or L; X9 is F or T;X10 is Y or A; X11 is Y, G, F, or S; X12 is L, Y, F or W; X13 is Y, N,A, T, G, F or I; X14 is H, V, P, T or I; X15 is A, W, R, P or T.

In a specific aspect, X1 is D; X2 is S and X3 is T. In another aspect,X4 is D; X5 is V; X6 is S; X7 is A; X8 is V; X9 is F; X10 is Y; X11 isY; X12 is L; X13 is Y; X14 is H; X15 is A. In yet another aspect, X1 isD; X2 is S and X3 is T, X4 is D; X5 is V; X6 is S; X7 is A; X8 is V; X9is F; X10 is Y; X11 is Y; X12 is L; X13 is Y; X14 is H and X15 is A.

In a further aspect, the heavy chain variable region comprises one ormore framework sequences juxtaposed between the HVRs as:(HC-FR1)-(HVR-H1)-(HC-FR2)-(HVR-H2)-(HC-FR3)-(HVR-H3)-(HC-FR4), and thelight chain variable regions comprises one or more framework sequencesjuxtaposed between the HVRs as:(LC-FR1)-(HVR-L1)-(LC-FR2)-(HVR-L2)-(LC-FR3)-(HVR-L3)-(LC-FR4). In astill further aspect, the framework sequences are derived from humanconsensus framework sequences. In a still further aspect, the heavychain framework sequences are derived from a Kabat subgroup I, II, orIII sequence. In a still further aspect, the heavy chain frameworksequence is a VH subgroup III consensus framework. In a still furtheraspect, one or more of the heavy chain framework sequences is thefollowing:

(SEQ ID NO: 4) HC-FR1 EVQLVESGGGLVQPGGSLRLSCAAS (SEQ ID NO: 5) HC-FR2WVRQAPGKGLEWV (SEQ ID NO: 6) HC-FR3 RFTISADTSKNTAYLQMNSLRAEDTAVYYCAR(SEQ ID NO: 7) HC-FR4 WGQGTLVTVSA.

In a still further aspect, the light chain framework sequences arederived from a Kabat kappa I, II, II or IV subgroup sequence. In a stillfurther aspect, the light chain framework sequences are VL kappa Iconsensus framework. In a still further aspect, one or more of the lightchain framework sequences is the following:

(SEQ ID NO: 11) LC-FR1 DIQMTQSPSSLSASVGDRVTITC (SEQ ID NO: 12) LC-FR2WYQQKPGKAPKLLIY (SEQ ID NO: 13) LC-FR3 GVPSRFSGSGSGTDFTLTISSLQPEDFATYYC(SEQ ID NO: 14) LC-FR4 FGQGTKVEIKR.

In a still further specific aspect, the antibody further comprises ahuman or murine constant region. In a still further aspect, the humanconstant region is selected from the group consisting of IgG1, IgG2,IgG2, IgG3, IgG4. In a still further specific aspect, the human constantregion is IgG1. In a still further aspect, the murine constant region isselected from the group consisting of IgG1, IgG2A, IgG2B, IgG3. In astill further aspect, the murine constant region if IgG2A. In a stillfurther specific aspect, the antibody has reduced or minimal effectorfunction. In a still further specific aspect the minimal effectorfunction results from an “effector-less Fc mutation” or aglycosylation.In still a further embodiment, the effector-less Fc mutation is an N297Aor D265A/N297A substitution in the constant region.

In yet another embodiment, provided is an anti-PD-L1 antibody comprisinga heavy chain and a light chain variable region sequence, wherein:

(a) the heavy chain further comprises and HVR-H1, HVR-H2 and an HVR-H3sequence having at least 85% sequence identity to GFTFSDSWIH (SEQ IDNO:15), AWISPYGGSTYYADSVKG (SEQ ID NO:16) and RHWPGGFDY (SEQ ID NO:3),respectively, or

(b) the light chain further comprises an HVR-L1, HVR-L2 and an HVR-L3sequence having at least 85% sequence identity to RASQDVSTAVA (SEQ IDNO:17), SASFLYS (SEQ ID NO:18) and QQYLYHPAT (SEQ ID NO:19),respectively.

In a specific aspect, the sequence identity is 86%, 87%, 88%, 89%, 90%,91%, 92%, 93%, 94%, 95%, 96%, 97%, 98%, 99% or 100%. In another aspect,the heavy chain variable region comprises one or more frameworksequences juxtaposed between the HVRs as:(HC-FR1)-(HVR-H1)-(HC-FR2)-(HVR-H2)-(HC-FR3)-(HVR-H3)-(HC-FR4), and thelight chain variable regions comprises one or more framework sequencesjuxtaposed between the HVRs as:(LC-FR1)-(HVR-L1)-(LC-FR2)-(HVR-L2)-(LC-FR3)-(HVR-L3)-(LC-FR4). In yetanother aspect, the framework sequences are derived from human consensusframework sequences. In a still further aspect, the heavy chainframework sequences are derived from a Kabat subgroup I, II, or IIIsequence. In a still further aspect, the heavy chain framework sequenceis a VH subgroup III consensus framework. In a still further aspect, oneor more of the heavy chain framework sequences is the following:

(SEQ ID NO: 4) HC-FR1 EVQLVESGGGLVQPGGSLRLSCAAS (SEQ ID NO: 5) HC-FR2WVRQAPGKGLEWV (SEQ ID NO: 6) HC-FR3 RFTISADTSKNTAYLQMNSLRAEDTAVYYCAR(SEQ ID NO: 7) HC-FR4 WGQGTLVTVSA.

In a still further aspect, the light chain framework sequences arederived from a Kabat kappa I, II, II or IV subgroup sequence. In a stillfurther aspect, the light chain framework sequences are VL kappa Iconsensus framework. In a still further aspect, one or more of the lightchain framework sequences is the following:

(SEQ ID NO: 11) LC-FR1 DIQMTQSPSSLSASVGDRVTITC (SEQ ID NO: 12) LC-FR2WYQQKPGKAPKLLIY (SEQ ID NO: 13) LC-FR3 GVPSRFSGSGSGTDFTLTISSLQPEDFATYYC(SEQ ID NO: 14) LC-FR4 FGQGTKVEIKR.

In a still further specific aspect, the antibody further comprises ahuman or murine constant region. In a still further aspect, the humanconstant region is selected from the group consisting of IgG1, IgG2,IgG2, IgG3, IgG4. In a still further specific aspect, the human constantregion is IgG1. In a still further aspect, the murine constant region isselected from the group consisting of IgG1, IgG2A, IgG2B, IgG3. In astill further aspect, the murine constant region if IgG2A. In a stillfurther specific aspect, the antibody has reduced or minimal effectorfunction. In a still further specific aspect the minimal effectorfunction results from an “effector-less Fc mutation” or aglycosylation.In still a further embodiment, the effector-less Fc mutation is an N297Aor D265A/N297A substitution in the constant region.

In a still further embodiment, provided is an isolated anti-PD-L1antibody comprising a heavy chain and a light chain variable regionsequence, wherein:

(a) the heavy chain sequence has at least 85% sequence identity to theheavy chain sequence:EVQLVESGGGLVQPGGSLRLSCAASGFTFSDSWIHWVRQAPGKGLEWVAWISPYGGSTYYADSVKGRFTISADTSKNTAYLQMNSLRAEDTAVYYCARRHWPGGFDYWG QGTLVTVSA (SEQID NO:20), or

(b) the light chain sequences has at least 85% sequence identity to thelight chain sequence: DIQMTQSPSSLSASVGDRVTITCRASQDVSTAVAWYQQKPGKAPKLLIYSASF LYSGVPSRFSGSGSGTDFTLTISSLQPEDFATYYCQQYLYHPATFGQGTKVEIKR (SEQ IDNO:21).

In a specific aspect, the sequence identity is 86%, 87%, 88%, 89%, 90%,91%, 92%, 93%, 94%, 95%, 96%, 97%, 98%, 99% or 100%. In another aspect,the heavy chain variable region comprises one or more frameworksequences juxtaposed between the HVRs as:(HC-FR1)-(HVR-H1)-(HC-FR2)-(HVR-H2)-(HC-FR3)-(HVR-H3)-(HC-FR4), and thelight chain variable regions comprises one or more framework sequencesjuxtaposed between the HVRs as:(LC-FR1)-(HVR-L1)-(LC-FR2)-(HVR-L2)-(LC-FR3)-(HVR-L3)-(LC-FR4). In yetanother aspect, the framework sequences are derived from human consensusframework sequences. In a further aspect, the heavy chain frameworksequences are derived from a Kabat subgroup I, II, or III sequence. In astill further aspect, the heavy chain framework sequence is a VHsubgroup III consensus framework. In a still further aspect, one or moreof the heavy chain framework sequences is the following:

(SEQ ID NO: 4) HC-FR1 EVQLVESGGGLVQPGGSLRLSCAAS (SEQ ID NO: 5) HC-FR2WVRQAPGKGLEWV (SEQ ID NO: 6) HC-FR3 RFTISADTSKNTAYLQMNSLRAEDTAVYYCAR(SEQ ID NO: 7) HC-FR4 WGQGTLVTVSA.

In a still further aspect, the light chain framework sequences arederived from a Kabat kappa I, II, II or IV subgroup sequence. In a stillfurther aspect, the light chain framework sequences are VL kappa Iconsensus framework. In a still further aspect, one or more of the lightchain framework sequences is the following:

(SEQ ID NO: 11) LC-FR1 DIQMTQSPSSLSASVGDRVTITC (SEQ ID NO: 12) LC-FR2WYQQKPGKAPKLLIY (SEQ ID NO: 13) LC-FR3 GVPSRFSGSGSGTDFTLTISSLQPEDFATYYC(SEQ ID NO: 14) LC-FR4 FGQGTKVEIKR.

In a still further specific aspect, the antibody further comprises ahuman or murine constant region. In a still further aspect, the humanconstant region is selected from the group consisting of IgG1, IgG2,IgG2, IgG3, IgG4. In a still further specific aspect, the human constantregion is IgG1. In a still further aspect, the murine constant region isselected from the group consisting of IgG1, IgG2A, IgG2B, IgG3. In astill further aspect, the murine constant region if IgG2A. In a stillfurther specific aspect, the antibody has reduced or minimal effectorfunction. In a still further specific aspect, the minimal effectorfunction results from production in prokaryotic cells. In a stillfurther specific aspect the minimal effector function results from an“effector-less Fc mutation” or aglycosylation. In still a furtherembodiment, the effector-less Fc mutation is an N297A or D265A/N297Asubstitution in the constant region.

In a still further embodiment, the invention provides for compositionscomprising any of the above described anti-PD-L1 antibodies incombination with at least one pharmaceutically-acceptable carrier.

In a still further embodiment, provided is an isolated nucleic acidencoding a light chain or a heavy chain variable region sequence of ananti-PD-L1 antibody, wherein:

(a) the heavy chain further comprises and HVR-H1, HVR-H2 and an HVR-H3sequence having at least 85% sequence identity to GFTFSDSWIH (SEQ IDNO:15), AWISPYGGSTYYADSVKG (SEQ ID NO:16) and RHWPGGFDY (SEQ ID NO:3),respectively, and

(b) the light chain further comprises an HVR-L1, HVR-L2 and an HVR-L3sequence having at least 85% sequence identity to RASQDVSTAVA (SEQ IDNO:17), SASFLYS (SEQ ID NO:18) and QQYLYHPAT (SEQ ID NO:19),respectively.

In a specific aspect, the sequence identity is 86%, 87%, 88%, 89%, 90%,91%, 92%, 93%, 94%, 95%, 96%, 97%, 98%, 99% or 100%. In aspect, theheavy chain variable region comprises one or more framework sequencesjuxtaposed between the HVRs as:(HC-FR1)-(HVR-H1)-(HC-FR2)-(HVR-H2)-(HC-FR3)-(HVR-H3)-(HC-FR4), and thelight chain variable regions comprises one or more framework sequencesjuxtaposed between the HVRs as:(LC-FR1)-(HVR-L1)-(LC-FR2)-(HVR-L2)-(LC-FR3)-(HVR-L3)-(LC-FR4). In yetanother aspect, the framework sequences are derived from human consensusframework sequences. In a further aspect, the heavy chain frameworksequences are derived from a Kabat subgroup I, II, or III sequence. In astill further aspect, the heavy chain framework sequence is a VHsubgroup III consensus framework. In a still further aspect, one or moreof the heavy chain framework sequences is the following:

(SEQ ID NO: 4) HC-FR1 EVQLVESGGGLVQPGGSLRLSCAAS (SEQ ID NO: 5) HC-FR2WVRQAPGKGLEWV (SEQ ID NO: 6) HC-FR3 RFTISADTSKNTAYLQMNSLRAEDTAVYYCAR(SEQ ID NO: 7) HC-FR4 WGQGTLVTVSA.

In a still further aspect, the light chain framework sequences arederived from a Kabat kappa I, II, II or IV subgroup sequence. In a stillfurther aspect, the light chain framework sequences are VL kappa Iconsensus framework. In a still further aspect, one or more of the lightchain framework sequences is the following:

(SEQ ID NO: 11) LC-FR1 DIQMTQSPSSLSASVGDRVTITC (SEQ ID NO: 12) LC-FR2WYQQKPGKAPKLLIY (SEQ ID NO: 13) LC-FR3 GVPSRFSGSGSGTDFTLTISSLQPEDFATYYC(SEQ ID NO: 14) LC-FR4 FGQGTKVEIKR.

In a still further specific aspect, the antibody further comprises ahuman or murine constant region. In a still further aspect, the humanconstant region is selected from the group consisting of IgG1, IgG2,IgG2, IgG3, IgG4. In a still further specific aspect, the human constantregion is IgG1. In a still further aspect, the murine constant region isselected from the group consisting of IgG1, IgG2A, IgG2B, IgG3. In astill further aspect, the murine constant region if IgG2A. In a stillfurther specific aspect, the antibody has reduced or minimal effectorfunction. In a still further specific aspect, the minimal effectorfunction results from production in prokaryotic cells. In a stillfurther specific aspect the minimal effector function results from an“effector-less Fc mutation” or aglycosylation. In still a furtheraspect, the effector-less Fc mutation is an N297A or D265A/N297Asubstitution in the constant region.

In a still further aspect, the nucleic acid further comprises a vectorsuitable for expression of the nucleic acid encoding any of thepreviously described anti-PD-L1 antibodies. In a still further specificaspect, the vector further comprises a host cell suitable for expressionof the nucleic acid. In a still further specific aspect, the host cellis a eukaryotic cell or a prokaryotic cell. In a still further specificaspect, the eukaryotic cell is a mammalian cell, such as Chinese HamsterOvary (CHO).

The anti-PD-L1 antibody or antigen binding fragment thereof, may be madeusing methods known in the art, for example, by a process comprisingculturing a host cell containing nucleic acid encoding any of thepreviously described anti-PD-L1 antibodies or antigen-binding fragmentin a form suitable for expression, under conditions suitable to producesuch antibody or fragment, and recovering the antibody or fragment. In astill further embodiment, the invention provides for a compositioncomprising an anti-PD-L1 antibody or antigen binding fragment thereof asprovided herein and at least one pharmaceutically acceptable carrier.

A. Antibodies

1. Antibody Affinity

In certain embodiments, an antibody provided herein has a dissociationconstant (Kd) of ≤1 μM. In one embodiment, Kd is measured by aradiolabeled antigen binding assay (RIA) performed with the Fab versionof an antibody of interest and its antigen as described by the followingassay. Solution binding affinity of Fabs for antigen is measured byequilibrating Fab with a minimal concentration of (¹²⁵I)-labeled antigenin the presence of a titration series of unlabeled antigen, thencapturing bound antigen with an anti-Fab antibody-coated plate (see,e.g., Chen et al., J. Mol. Biol. 293:865-881 (1999)). To establishconditions for the assay, MICROTITER® multi-well plates (ThermoScientific) are coated overnight with 5 μg/ml of a capturing anti-Fabantibody (Cappel Labs) in 50 mM sodium carbonate (pH 9.6), andsubsequently blocked with 2% (w/v) bovine serum albumin in PBS for twoto five hours at room temperature (approximately 23° C.). In anon-adsorbent plate (Nunc #269620), 100 pM or 26 pM [¹²⁵I]-antigen aremixed with serial dilutions of a Fab of interest (e.g., consistent withassessment of the anti-VEGF antibody, Fab-12, in Presta et al., CancerRes. 57:4593-4599 (1997)). The Fab of interest is then incubatedovernight; however, the incubation may continue for a longer period(e.g., about 65 hours) to ensure that equilibrium is reached.Thereafter, the mixtures are transferred to the capture plate forincubation at room temperature (e.g., for one hour). The solution isthen removed and the plate washed eight times with 0.1% polysorbate 20(TWEEN-20®) in PBS. When the plates have dried, 150 μl/well ofscintillant (MICROSCINT-20™; Packard) is added, and the plates arecounted on a TOPCOUNT™ gamma counter (Packard) for ten minutes.Concentrations of each Fab that give less than or equal to 20% ofmaximal binding are chosen for use in competitive binding assays.

According to another embodiment, Kd is measured using surface plasmonresonance assays using a BIACORE®-2000 or a BIACORE®-3000 (BIAcore,Inc., Piscataway, N.J.) at 25° C. with immobilized antigen CM5 chips at˜10 response units (RU). Briefly, carboxymethylated dextran biosensorchips (CM5, BIACORE, Inc.) are activated withN-ethyl-N′-(3-dimethylaminopropyl)-carbodiimide hydrochloride (EDC) andN-hydroxysuccinimide (NHS) according to the supplier's instructions.Antigen is diluted with 10 mM sodium acetate, pH 4.8, to 5 μg/ml (˜0.2λM) before injection at a flow rate of 5 μl/minute to achieveapproximately 10 response units (RU) of coupled protein. Following theinjection of antigen, 1 M ethanolamine is injected to block unreactedgroups. For kinetics measurements, two-fold serial dilutions of Fab(0.78 nM to 500 nM) are injected in PBS with 0.05% polysorbate 20(TWEEN-20™) surfactant (PBST) at 25° C. at a flow rate of approximately25 μl/min. Association rates (k_(on)) and dissociation rates (k_(off))are calculated using a simple one-to-one Langmuir binding model(BIACORE® Evaluation Software version 3.2) by simultaneously fitting theassociation and dissociation sensorgrams. The equilibrium dissociationconstant (Kd) is calculated as the ratio k_(off)/k_(on). See, e.g., Chenet at., J. Mol. Biol. 293:865-881 (1999). If the on-rate exceeds 10⁶ M⁻¹s⁻¹ by the surface plasmon resonance assay above, then the on-rate canbe determined by using a fluorescent quenching technique that measuresthe increase or decrease in fluorescence emission intensity(excitation=295 nm; emission=340 nm, 16 nm band-pass) at 25° C. of a 20nM anti-antigen antibody (Fab form) in PBS, pH 7.2, in the presence ofincreasing concentrations of antigen as measured in a spectrometer, suchas a stop-flow equipped spectrophometer (Aviv Instruments) or a8000-series SLM-AMINCO™ spectrophotometer (ThermoSpectronic) with astirred cuvette.

2. Antibody Fragments

In certain embodiments, an antibody provided herein is an antibodyfragment. Antibody fragments include, but are not limited to, Fab, Fab′,Fab′-SH, F(ab′)₂, Fv, and scFv fragments, and other fragments describedbelow. For a review of certain antibody fragments, see Hudson et al.Nat. Med. 9:129-134 (2003). For a review of scFv fragments, see, e.g.,Pluckthün, in The Pharmacology of Monoclonal Antibodies, vol. 113,Rosenburg and Moore eds., (Springer-Verlag, New York), pp. 269-315(1994); see also WO 93/16185; and U.S. Pat. Nos. 5,571,894 and5,587,458. For discussion of Fab and F(ab′)₂ fragments comprisingsalvage receptor binding epitope residues and having increased in vivohalf-life, see U.S. Pat. No. 5,869,046.

Diabodies are antibody fragments with two antigen-binding sites that maybe bivalent or bispecific. See, for example, EP 404,097; WO 1993/01161;Hudson et al., Nat. Med. 9:129-134 (2003); and Hollinger et al., Proc.Natl. Acad. Sci. USA 90: 6444-6448 (1993). Triabodies and tetrabodiesare also described in Hudson et al., Nat. Med. 9:129-134 (2003).

Single-domain antibodies are antibody fragments comprising all or aportion of the heavy chain variable domain or all or a portion of thelight chain variable domain of an antibody. In certain embodiments, asingle-domain antibody is a human single-domain antibody (Domantis,Inc., Waltham, Mass.; see, e.g., U.S. Pat. No. 6,248,516 B1).

Antibody fragments can be made by various techniques, including but notlimited to proteolytic digestion of an intact antibody as well asproduction by recombinant host cells (e.g., E. coli or phage), asdescribed herein.

3. Chimeric and Humanized Antibodies

In certain embodiments, an antibody provided herein is a chimericantibody. Certain chimeric antibodies are described, e.g., in U.S. Pat.No. 4,816,567; and Morrison et al., Proc. Natl. Acad. Sci. USA,81:6851-6855 (1984)). In one example, a chimeric antibody comprises anon-human variable region (e.g., a variable region derived from a mouse,rat, hamster, rabbit, or non-human primate, such as a monkey) and ahuman constant region. In a further example, a chimeric antibody is a“class switched” antibody in which the class or subclass has beenchanged from that of the parent antibody. Chimeric antibodies includeantigen-binding fragments thereof.

In certain embodiments, a chimeric antibody is a humanized antibody.Typically, a non-human antibody is humanized to reduce immunogenicity tohumans, while retaining the specificity and affinity of the parentalnon-human antibody. Generally, a humanized antibody comprises one ormore variable domains in which HVRs, e.g., CDRs, (or portions thereof)are derived from a non-human antibody, and FRs (or portions thereof) arederived from human antibody sequences. A humanized antibody optionallywill also comprise at least a portion of a human constant region. Insome embodiments, some FR residues in a humanized antibody aresubstituted with corresponding residues from a non-human antibody (e.g.,the antibody from which the HVR residues are derived), e.g., to restoreor improve antibody specificity or affinity.

Humanized antibodies and methods of making them are reviewed, e.g., inAlmagro and Fransson, Front. Biosci. 13:1619-1633 (2008), and arefurther described, e.g., in Riechmann et al., Nature 332:323-329 (1988);Queen et al., Proc. Nat'l Acad. Sci. USA 86:10029-10033 (1989); U.S.Pat. Nos. 5,821,337, 7,527,791, 6,982,321, and 7,087,409; Kashmiri etal., Methods 36:25-34 (2005) (describing SDR (a-CDR) grafting); Padlan,Mol. Immunol. 28:489-498 (1991) (describing “resurfacing”); Dall'Acquaet al., Methods 36:43-60 (2005) (describing “FR shuffling”); and Osbournet al., Methods 36:61-68 (2005) and Klimka et al., Br. J. Cancer,83:252-260 (2000) (describing the “guided selection” approach to FRshuffling).

Human framework regions that may be used for humanization include butare not limited to: framework regions selected using the “best-fit”method (see, e.g., Sims et al. J. Immunol. 151:2296 (1993)); frameworkregions derived from the consensus sequence of human antibodies of aparticular subgroup of light or heavy chain variable regions (see, e.g.,Carter et al. Proc. Natl. Acad. Sci. USA, 89:4285 (1992); and Presta etal. J. Immunol., 151:2623 (1993)); human mature (somatically mutated)framework regions or human germline framework regions (see, e.g.,Almagro and Fransson, Front. Biosci. 13:1619-1633 (2008)); and frameworkregions derived from screening FR libraries (see, e.g., Baca et al., J.Biol. Chem. 272:10678-10684 (1997) and Rosok et al., J. Biol. Chem.271:22611-22618 (1996)).

4. Human Antibodies

In certain embodiments, an antibody provided herein is a human antibody.Human antibodies can be produced using various techniques known in theart. Human antibodies are described generally in van Dijk and van deWinkel, Curr. Opin. Pharmacol. 5: 368-74 (2001) and Lonberg, Curr. Opin.Immunol. 20:450-459 (2008).

Human antibodies may be prepared by administering an immunogen to atransgenic animal that has been modified to produce intact humanantibodies or intact antibodies with human variable regions in responseto antigenic challenge. Such animals typically contain all or a portionof the human immunoglobulin loci, which replace the endogenousimmunoglobulin loci, or which are present extrachromosomally orintegrated randomly into the animal's chromosomes. In such transgenicmice, the endogenous immunoglobulin loci have generally beeninactivated. For review of methods for obtaining human antibodies fromtransgenic animals, see Lonberg, Nat. Biotech. 23:1117-1125 (2005). Seealso, e.g., U.S. Pat. Nos. 6,075,181 and 6,150,584 describing XENOMOUSE™technology; U.S. Pat. No. 5,770,429 describing HuMab® technology; U.S.Pat. No. 7,041,870 describing K-M MOUSE® technology, and U.S. PatentApplication Publication No. US 2007/0061900, describing VelociMouse®technology). Human variable regions from intact antibodies generated bysuch animals may be further modified, e.g., by combining with adifferent human constant region.

Human antibodies can also be made by hybridoma-based methods. Humanmyeloma and mouse-human heteromyeloma cell lines for the production ofhuman monoclonal antibodies have been described. (See, e.g., Kozbor J.Immunol., 133: 3001 (1984); Brodeur et al., Monoclonal AntibodyProduction Techniques and Applications, pp. 51-63 (Marcel Dekker, Inc.,New York, 1987); and Boerner et al., J. Immunol., 147: 86 (1991).) Humanantibodies generated via human B-cell hybridoma technology are alsodescribed in Li et al., Proc. Natl. Acad. Sci. USA, 103:3557-3562(2006). Additional methods include those described, for example, in U.S.Pat. No. 7,189,826 (describing production of monoclonal human IgMantibodies from hybridoma cell lines) and Ni, Xiandai Mianyixue,26(4):265-268 (2006) (describing human-human hybridomas). Humanhybridoma technology (Trioma technology) is also described in Vollmersand Brandlein, Histology and Histopathology, 20(3):927-937 (2005) andVollmers and Brandlein, Methods and Findings in Experimental andClinical Pharmacology, 27(3):185-91 (2005).

Human antibodies may also be generated by isolating Fv clone variabledomain sequences selected from human-derived phage display libraries.Such variable domain sequences may then be combined with a desired humanconstant domain. Techniques for selecting human antibodies from antibodylibraries are described below.

5. Library-Derived Antibodies

Antibodies may be isolated by screening combinatorial libraries forantibodies with the desired activity or activities. For example, avariety of methods are known in the art for generating phage displaylibraries and screening such libraries for antibodies possessing thedesired binding characteristics. Such methods are reviewed, e.g., inHoogenboom et al. in Methods in Molecular Biology 178:1-37 (O'Brien etal., ed., Human Press, Totowa, N.J., 2001) and further described, e.g.,in the McCafferty et al., Nature 348:552-554; Clackson et al., Nature352: 624-628 (1991); Marks et al., J. Mol. Biol. 222: 581-597 (1992);Marks and Bradbury, in Methods in Molecular Biology 248:161-175 (Lo,ed., Human Press, Totowa, N.J., 2003); Sidhu et al., J. Mol. Biol.338(2): 299-310 (2004); Lee et al., J. Mol. Biol. 340(5): 1073-1093(2004); Fellouse, Proc. Natl. Acad. Sci. USA 101(34): 12467-12472(2004); and Lee et al., J. Immunol. Methods 284(1-2): 119-132(2004).

In certain phage display methods, repertoires of VH and VL genes areseparately cloned by polymerase chain reaction (PCR) and recombinedrandomly in phage libraries, which can then be screened forantigen-binding phage as described in Winter et al., Ann. Rev. Immunol.,12: 433-455 (1994). Phage typically display antibody fragments, eitheras single-chain Fv (scFv) fragments or as Fab fragments. Libraries fromimmunized sources provide high-affinity antibodies to the immunogenwithout the requirement of constructing hybridomas. Alternatively, thenaive repertoire can be cloned (e.g., from human) to provide a singlesource of antibodies to a wide range of non-self and also self antigenswithout any immunization as described by Griffiths et al., EMBO J, 12:725-734 (1993). Finally, naive libraries can also be made syntheticallyby cloning unrearranged V-gene segments from stem cells, and using PCRprimers containing random sequence to encode the highly variable CDR3regions and to accomplish rearrangement in vitro, as described byHoogenboom and Winter, J. Mol. Biol., 227: 381-388 (1992). Patentpublications describing human antibody phage libraries include, forexample: U.S. Pat. No. 5,750,373, and US Patent Publication Nos.2005/0079574, 2005/0119455, 2005/0266000, 2007/0117126, 2007/0160598,2007/0237764, 2007/0292936, and 2009/0002360.

Antibodies or antibody fragments isolated from human antibody librariesare considered human antibodies or human antibody fragments herein.

6. Multispecific Antibodies

In certain embodiments, an antibody provided herein is a multispecificantibody, e.g., a bispecific antibody. Multispecific antibodies aremonoclonal antibodies that have binding specificities for at least twodifferent sites. In certain embodiments, one of the bindingspecificities is for PD-L1 and the other is for any other antigen. Incertain embodiments, bispecific antibodies may bind to two differentepitopes of PD-L1. Bispecific antibodies may also be used to localizecytotoxic agents to cells which express PD-L1. Bispecific antibodies canbe prepared as full length antibodies or antibody fragments.

Techniques for making multispecific antibodies include, but are notlimited to, recombinant co-expression of two immunoglobulin heavychain-light chain pairs having different specificities (see Milstein andCuello, Nature 305: 537 (1983)), WO 93/08829, and Traunecker et al.,EMBO J. 10: 3655 (1991)), and “knob-in-hole” engineering (see, e.g.,U.S. Pat. No. 5,731,168). Multi-specific antibodies may also be made byengineering electrostatic steering effects for making antibodyFc-heterodimeric molecules (WO 2009/089004A1); cross-linking two or moreantibodies or fragments (see, e.g., U.S. Pat. No. 4,676,980, and Brennanet al., Science, 229: 81 (1985)); using leucine zippers to producebi-specific antibodies (see, e.g., Kostelny et al., J. Immunol.,148(5):1547-1553 (1992)); using “diabody” technology for makingbispecific antibody fragments (see, e.g., Hollinger et al., Proc. Natl.Acad. Sci. USA, 90:6444-6448 (1993)); and using single-chain Fv (sFv)dimers (see, e.g., Gruber et al., J. Immunol., 152:5368 (1994)); andpreparing trispecific antibodies as described, e.g., in Tutt et al. J.Immunol. 147: 60 (1991).

Engineered antibodies with three or more functional antigen bindingsites, including “Octopus antibodies,” are also included herein (see,e.g., US 2006/0025576A1).

The antibody or fragment herein also includes a “Dual Acting FAb” or“DAF” comprising an antigen binding site that binds to PD-L1 as well asanother, different antigen.

7. Antibody Variants

a) Glycosylation Variants

In certain embodiments, an antibody provided herein is altered toincrease or decrease the extent to which the antibody is glycosylated.Addition or deletion of glycosylation sites to an antibody may beconveniently accomplished by altering the amino acid sequence such thatone or more glycosylation sites is created or removed.

Where the antibody comprises an Fc region, the carbohydrate attachedthereto may be altered. Native antibodies produced by mammalian cellstypically comprise a branched, biantennary oligosaccharide that isgenerally attached by an N-linkage to Asn297 of the CH2 domain of the Fcregion. See, e.g., Wright et al. TIBTECH 15:26-32 (1997). Theoligosaccharide may include various carbohydrates, e.g., mannose,N-acetyl glucosamine (GlcNAc), galactose, and sialic acid, as well as afucose attached to a GlcNAc in the “stem” of the biantennaryoligosaccharide structure. In some embodiments, modifications of theoligosaccharide in an antibody may be made in order to create antibodyvariants with certain improved properties.

In one embodiment, antibody variants are provided having a carbohydratestructure that lacks fucose attached (directly or indirectly) to an Fcregion. For example, the amount of fucose in such antibody may be from1% to 80%, from 1% to 65%, from 5% to 65% or from 20% to 40%. The amountof fucose is determined by calculating the average amount of fucosewithin the sugar chain at Asn297, relative to the sum of allglycostructures attached to Asn 297 (e. g. complex, hybrid and highmannose structures) as measured by MALDI-TOF mass spectrometry, asdescribed in WO 2008/077546, for example. Asn297 refers to theasparagine residue located at about position 297 in the Fc region (Eunumbering of Fc region residues); however, Asn297 may also be locatedabout ±3 amino acids upstream or downstream of position 297, i.e.,between positions 294 and 300, due to minor sequence variations inantibodies. Such fucosylation variants may have improved ADCC function.See, e.g., US Patent Publication Nos. US 2003/0157108 (Presta, L.); US2004/0093621 (Kyowa Hakko Kogyo Co., Ltd). Examples of publicationsrelated to “defucosylated” or “fucose-deficient” antibody variantsinclude: US 2003/0157108; WO 2000/61739; WO 2001/29246; US 2003/0115614;US 2002/0164328; US 2004/0093621; US 2004/0132140; US 2004/0110704; US2004/0110282; US 2004/0109865; WO 2003/085119; WO 2003/084570; WO2005/035586; WO 2005/035778; WO 2005/053742; WO 2002/031140; Okazaki etal. J. Mol. Biol. 336:1239-1249 (2004); Yamane-Ohnuki et al., Biotech.Bioeng. 87: 614 (2004). Examples of cell lines capable of producingdefucosylated antibodies include Lec13 CHO cells deficient in proteinfucosylation (Ripka et al. Arch. Biochem. Biophys. 249:533-545 (1986);US Pat Appl No US 2003/0157108 A1, Presta, L; and WO 2004/056312 A1,Adams et al., especially at Example 11), and knockout cell lines, suchas alpha-1,6-fucosyltransferase gene, FUT8, knockout CHO cells (see,e.g., Yamane-Ohnuki et al. Biotech. Bioeng. 87: 614 (2004); Kanda, Y. etal., Biotechnol. Bioeng., 94(4):680-688 (2006); and WO 2003/085107).

Antibodies variants are further provided with bisected oligosaccharides,e.g., in which a biantennary oligosaccharide attached to the Fc regionof the antibody is bisected by GlcNAc. Such antibody variants may havereduced fucosylation and/or improved ADCC function. Examples of suchantibody variants are described, e.g., in WO 2003/011878 (Jean-Mairet etal.); U.S. Pat. No. 6,602,684 (Umana et al.); and US 2005/0123546 (Umanaet al.). Antibody variants with at least one galactose residue in theoligosaccharide attached to the Fc region are also provided. Suchantibody variants may have improved CDC function. Such antibody variantsare described, e.g., in WO 1997/30087 (Patel et al.); WO 1998/58964(Raju, S.); and WO 1999/22764 (Raju, S.).

b) Fc Region Variants

In certain embodiments, one or more amino acid modifications may beintroduced into the Fc region of an antibody provided herein, therebygenerating an Fc region variant. The Fc region variant may comprise ahuman Fc region sequence (e.g., a human IgG1, IgG2, IgG3 or IgG4 Fcregion) comprising an amino acid modification (e.g., a substitution) atone or more amino acid positions.

In certain embodiments, the invention contemplates an antibody variantthat possesses some but not all effector functions, which make it adesirable candidate for applications in which the half life of theantibody in vivo is important yet certain effector functions (such ascomplement and ADCC) are unnecessary or deleterious. In vitro and/or invivo cytotoxicity assays can be conducted to confirm thereduction/depletion of CDC and/or ADCC activities. For example, Fcreceptor (FcR) binding assays can be conducted to ensure that theantibody lacks FcγR binding (hence likely lacking ADCC activity), butretains FcRn binding ability. The primary cells for mediating ADCC, NKcells, express Fc(RIII only, whereas monocytes express Fc(RI, Fc(RII andFc(RIII. FcR expression on hematopoetic cells is summarized in Table 3on page 464 of Ravetch and Kinet, Annu. Rev. Immunol. 9:457-492 (1991).Non-limiting examples of in vitro assays to assess ADCC activity of amolecule of interest is described in U.S. Pat. No. 5,500,362 (see, e.g.,Hellstrom, I. et al. Proc. Nat'l Acad. Sci. USA 83:7059-7063 (1986)) andHellstrom, I et al., Proc. Nat'l Acad. Sci. USA 82:1499-1502 (1985);U.S. Pat. No. 5,821,337 (see Bruggemann, M. et al., J. Exp. Med.166:1351-1361 (1987)). Alternatively, non-radioactive assays methods maybe employed (see, for example, ACTI™ non-radioactive cytotoxicity assayfor flow cytometry (Cell Technology, Inc. Mountain View, Calif.; andCytoTox 96® non-radioactive cytotoxicity assay (Promega, Madison, Wis.).Useful effector cells for such assays include peripheral bloodmononuclear cells (PBMC) and Natural Killer (NK) cells. Alternatively,or additionally, ADCC activity of the molecule of interest may beassessed in vivo, e.g., in a animal model such as that disclosed inClynes et al. Proc. Nat'l Acad. Sci. USA 95:652-656 (1998). C1q bindingassays may also be carried out to confirm that the antibody is unable tobind C1q and hence lacks CDC activity. See, e.g., C1q and C3c bindingELISA in WO 2006/029879 and WO 2005/100402. To assess complementactivation, a CDC assay may be performed (see, for example,Gazzano-Santoro et al., J. Immunol. Methods 202:163 (1996); Cragg, M. S.et al., Blood 101:1045-1052 (2003); and Cragg, M. S. and M. J. Glennie,Blood 103:2738-2743 (2004)). FcRn binding and in vivo clearance/halflife determinations can also be performed using methods known in the art(see, e.g., Petkova, S. B. et al., Int'l. Immunol. 18(12):1759-1769(2006)).

Antibodies with reduced effector function include those withsubstitution of one or more of Fc region residues 238, 265, 269, 270,297, 327 and 329 (U.S. Pat. No. 6,737,056). Such Fc mutants include Fcmutants with substitutions at two or more of amino acid positions 265,269, 270, 297 and 327, including the so-called “DANA” Fc mutant withsubstitution of residues 265 and 297 to alanine (U.S. Pat. No.7,332,581).

Certain antibody variants with improved or diminished binding to FcRsare described. (See, e.g., U.S. Pat. No. 6,737,056; WO 2004/056312, andShields et al., J. Biol. Chem. 9(2): 6591-6604 (2001).) In certainembodiments, an antibody variant comprises an Fc region with one or moreamino acid substitutions which improve ADCC, e.g., substitutions atpositions 298, 333, and/or 334 of the Fc region (EU numbering ofresidues). In some embodiments, alterations are made in the Fc regionthat result in altered (i.e., either improved or diminished) C1q bindingand/or Complement Dependent Cytotoxicity (CDC), e.g., as described inU.S. Pat. No. 6,194,551, WO 99/51642, and Idusogie et al. J. Immunol.164: 4178-4184 (2000).

Antibodies with increased half lives and improved binding to theneonatal Fc receptor (FcRn), which is responsible for the transfer ofmaternal IgGs to the fetus (Guyer et al., J. Immunol. 117:587 (1976) andKim et al., J. Immunol. 24:249 (1994)), are described in US2005/0014934A1 (Hinton et al.). Those antibodies comprise an Fc regionwith one or more substitutions therein which improve binding of the Fcregion to FcRn. Such Fc variants include those with substitutions at oneor more of Fc region residues: 238, 256, 265, 272, 286, 303, 305, 307,311, 312, 317, 340, 356, 360, 362, 376, 378, 380, 382, 413, 424 or 434,e.g., substitution of Fc region residue 434 (U.S. Pat. No. 7,371,826).See also Duncan & Winter, Nature 322:738-40 (1988); U.S. Pat. Nos.5,648,260 and 5,624,821; and WO 94/29351 concerning other examples of Fcregion variants.

c) Cysteine Engineered Antibody Variants

In certain embodiments, it may be desirable to create cysteineengineered antibodies, e.g., “thioMAbs,” in which one or more residuesof an antibody are substituted with cysteine residues. In particularembodiments, the substituted residues occur at accessible sites of theantibody. By substituting those residues with cysteine, reactive thiolgroups are thereby positioned at accessible sites of the antibody andmay be used to conjugate the antibody to other moieties, such as drugmoieties or linker-drug moieties, to create an immunoconjugate, asdescribed further herein. In certain embodiments, any one or more of thefollowing residues may be substituted with cysteine: V205 (Kabatnumbering) of the light chain; A118 (EU numbering) of the heavy chain;and S400 (EU numbering) of the heavy chain Fc region. Cysteineengineered antibodies may be generated as described, e.g., in U.S. Pat.No. 7,521,541.

d) Immunoconjugates

Further provided herein are immunoconjugates comprising an anti-PD-L1antibody herein conjugated to one or more cytotoxic agents, such aschemotherapeutic agents or drugs, growth inhibitory agents, toxins(e.g., protein toxins, enzymatically active toxins of bacterial, fungal,plant, or animal origin, or fragments thereof), or radioactive isotopes.

In one embodiment, an immunoconjugate is an antibody-drug conjugate(ADC) in which an antibody is conjugated to one or more drugs, includingbut not limited to a maytansinoid (see U.S. Pat. Nos. 5,208,020,5,416,064 and European Patent EP 0 425 235 B1); an auristatin such asmonomethylauristatin drug moieties DE and DF (MMAE and MMAF) (see U.S.Pat. Nos. 5,635,483 and 5,780,588, and 7,498,298); a dolastatin; acalicheamicin or derivative thereof (see U.S. Pat. Nos. 5,712,374,5,714,586, 5,739,116, 5,767,285, 5,770,701, 5,770,710, 5,773,001, and5,877,296; Hinman et al., Cancer Res. 53:3336-3342 (1993); and Lode etal., Cancer Res. 58:2925-2928 (1998)); an anthracycline such asdaunomycin or doxorubicin (see Kratz et al., Current Med. Chem.13:477-523 (2006); Jeffrey et al., Bioorganic & Med. Chem. Letters16:358-362 (2006); Torgov et al., Bioconj. Chem. 16:717-721 (2005); Nagyet al., Proc. Natl. Acad. Sci. USA 97:829-834 (2000); Dubowchik et al.,Bioorg. & Med. Chem. Letters 12:1529-1532 (2002); King et al., J. Med.Chem. 45:4336-4343 (2002); and U.S. Pat. No. 6,630,579); methotrexate;vindesine; a taxane such as docetaxel, paclitaxel, larotaxel, tesetaxel,and ortataxel; a trichothecene; and CC 1065.

In another embodiment, an immunoconjugate comprises an antibody asdescribed herein conjugated to an enzymatically active toxin or fragmentthereof, including but not limited to diphtheria A chain, nonbindingactive fragments of diphtheria toxin, exotoxin A chain (from Pseudomonasaeruginosa), ricin A chain, abrin A chain, modeccin A chain,alpha-sarcin, Aleurites fordii proteins, dianthin proteins, Phytolacaamericana proteins (PAPI, PAPII, and PAP-S), Momordica charantiainhibitor, curcin, crotin, Sapaonaria officinalis inhibitor, gelonin,mitogellin, restrictocin, phenomycin, enomycin, and the tricothecenes.

In another embodiment, an immunoconjugate comprises an antibody asdescribed herein conjugated to a radioactive atom to form aradioconjugate. A variety of radioactive isotopes are available for theproduction of radioconjugates. Examples include At²¹¹, I¹³¹, I¹²⁵, Y⁹⁰,Re¹⁸⁶, Re¹⁸⁸, Sm¹⁵³, Bi²¹², P³², Pb 212 and radioactive isotopes of Lu.When the radioconjugate is used for detection, it may comprise aradioactive atom for scintigraphic studies, for example tc⁹⁹ or I¹²³, ora spin label for nuclear magnetic resonance (NMR) imaging (also known asmagnetic resonance imaging, mri), such as iodine-123 again, iodine-131,indium-111, fluorine-19, carbon-13, nitrogen-15, oxygen-17, gadolinium,manganese or iron.

Conjugates of an antibody and cytotoxic agent may be made using avariety of bifunctional protein coupling agents such asN-succinimidyl-3-(2-pyridyldithio) propionate (SPDP),succinimidyl-4-(N-maleimidomethyl) cyclohexane-1-carboxylate (SMCC),iminothiolane (IT), bifunctional derivatives of imidoesters (such asdimethyl adipimidate HCl), active esters (such as disuccinimidylsuberate), aldehydes (such as glutaraldehyde), bis-azido compounds (suchas bis (p-azidobenzoyl) hexanediamine), bis-diazonium derivatives (suchas bis-(p-diazoniumbenzoyl)-ethylenediamine), diisocyanates (such astoluene 2,6-diisocyanate), and bis-active fluorine compounds (such as1,5-difluoro-2,4-dinitrobenzene). For example, a ricin immunotoxin canbe prepared as described in Vitetta et al., Science 238:1098 (1987).Carbon-14-labeled 1-isothiocyanatobenzyl-3-methyldiethylenetriaminepentaacetic acid (MX-DTPA) is an exemplary chelating agent forconjugation of radionucleotide to the antibody. See WO 94/11026. Thelinker may be a “cleavable linker” facilitating release of a cytotoxicdrug in the cell. For example, an acid-labile linker,peptidase-sensitive linker, photolabile linker, dimethyl linker ordisulfide-containing linker (Chari et al., Cancer Res. 52:127-131(1992); U.S. Pat. No. 5,208,020) may be used.

The immunuoconjugates or ADCs herein expressly contemplate, but are notlimited to such conjugates prepared with cross-linker reagentsincluding, but not limited to, BMPS, EMCS, GMBS, HBVS, LC-SMCC, MBS,MPBH, SBAP, SIA, SIAB, SMCC, SMPB, SMPH, sulfo-EMCS, sulfo-GMBS,sulfo-KMUS, sulfo-MBS, sulfo-SIAB, sulfo-SMCC, and sulfo-SMPB, and SVSB(succinimidyl-(4-vinylsulfone)benzoate) which are commercially available(e.g., from Pierce Biotechnology, Inc., Rockford, Ill., U.S.A.).

C. Binding Polypeptides

Binding polypeptides are polypeptides that bind, preferablyspecifically, to PD-L1 as described herein. In some embodiments, thebinding polypeptides are PD-L1 axis binding antagonist. Bindingpolypeptides may be chemically synthesized using known polypeptidesynthesis methodology or may be prepared and purified using recombinanttechnology. Binding polypeptides are usually at least about 5 aminoacids in length, alternatively at least about 6, 7, 8, 9, 10, 11, 12,13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30,31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48,49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66,67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84,85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, or 100 aminoacids in length or more, wherein such binding polypeptides that arecapable of binding, preferably specifically, to a target, PD-L1, asdescribed herein. Binding polypeptides may be identified without undueexperimentation using well known techniques. In this regard, it is notedthat techniques for screening polypeptide libraries for bindingpolypeptides that are capable of specifically binding to a polypeptidetarget are well known in the art (see, e.g., U.S. Pat. Nos. 5,556,762,5,750,373, 4,708,871, 4,833,092, 5,223,409, 5,403,484, 5,571,689,5,663,143; PCT Publication Nos. WO 84/03506 and WO 84/03564; Geysen etal., Proc. Natl. Acad. Sci. U.S.A., 81:3998-4002 (1984); Geysen et al.,Proc. Natl. Acad. Sci. U.S.A., 82:178-182 (1985); Geysen et al., inSynthetic Peptides as Antigens, 130-149 (1986); Geysen et al., J.Immunol. Meth., 102:259-274 (1987); Schoofs et al., J. Immunol.,140:611-616 (1988), Cwirla, S. E. et al. (1990) Proc. Natl. Acad. Sci.USA, 87:6378; Lowman, H. B. et al. (1991) Biochemistry, 30:10832;Clackson, T. et al. (1991) Nature, 352: 624; Marks, J. D. et al. (1991),J. Mol. Biol., 222:581; Kang, A. S. et al. (1991) Proc. Natl. Acad. Sci.USA, 88:8363, and Smith, G. P. (1991) Current Opin. Biotechnol., 2:668).

In this regard, bacteriophage (phage) display is one well knowntechnique which allows one to screen large polypeptide libraries toidentify member(s) of those libraries which are capable of specificallybinding to a target polypeptide, PD-L1. Phage display is a technique bywhich variant polypeptides are displayed as fusion proteins to the coatprotein on the surface of bacteriophage particles (Scott, J. K. andSmith, G. P. (1990) Science, 249: 386). The utility of phage displaylies in the fact that large libraries of selectively randomized proteinvariants (or randomly cloned cDNAs) can be rapidly and efficientlysorted for those sequences that bind to a target molecule with highaffinity. Display of peptide (Cwirla, S. E. et al. (1990) Proc. Natl.Acad. Sci. USA, 87:6378) or protein (Lowman, H. B. et al. (1991)Biochemistry, 30:10832; Clackson, T. et al. (1991) Nature, 352: 624;Marks, J. D. et al. (1991), J. Mol. Biol., 222:581; Kang, A. S. et al.(1991) Proc. Natl. Acad. Sci. USA, 88:8363) libraries on phage have beenused for screening millions of polypeptides or oligopeptides for oneswith specific binding properties (Smith, G. P. (1991) Current Opin.Biotechnol., 2:668). Sorting phage libraries of random mutants requiresa strategy for constructing and propagating a large number of variants,a procedure for affinity purification using the target receptor, and ameans of evaluating the results of binding enrichments. U.S. Pat. Nos.5,223,409, 5,403,484, 5,571,689, and 5,663,143.

Although most phage display methods have used filamentous phage,lambdoid phage display systems (WO 95/34683; U.S. Pat. No. 5,627,024),T4 phage display systems (Ren et al., Gene, 215: 439 (1998); Zhu et al.,Cancer Research, 58(15): 3209-3214 (1998); Jiang et al., Infection &Immunity, 65(11): 4770-4777 (1997); Ren et al., Gene, 195(2):303-311(1997); Ren, Protein Sci., 5: 1833 (1996); Efimov et al., Virus Genes,10: 173 (1995)) and T7 phage display systems (Smith and Scott, Methodsin Enzymology, 217: 228-257 (1993); U.S. Pat. No. 5,766,905) are alsoknown.

Additional improvements enhance the ability of display systems to screenpeptide libraries for binding to selected target molecules and todisplay functional proteins with the potential of screening theseproteins for desired properties. Combinatorial reaction devices forphage display reactions have been developed (WO 98/14277) and phagedisplay libraries have been used to analyze and control bimolecularinteractions (WO 98/20169; WO 98/20159) and properties of constrainedhelical peptides (WO 98/20036). WO 97/35196 describes a method ofisolating an affinity ligand in which a phage display library iscontacted with one solution in which the ligand will bind to a targetmolecule and a second solution in which the affinity ligand will notbind to the target molecule, to selectively isolate binding ligands. WO97/46251 describes a method of biopanning a random phage display librarywith an affinity purified antibody and then isolating binding phage,followed by a micropanning process using microplate wells to isolatehigh affinity binding phage. The use of Staphlylococcus aureus protein Aas an affinity tag has also been reported (Li et al. (1998) MolBiotech., 9:187). WO 97/47314 describes the use of substrate subtractionlibraries to distinguish enzyme specificities using a combinatoriallibrary which may be a phage display library. A method for selectingenzymes suitable for use in detergents using phage display is describedin WO 97/09446. Additional methods of selecting specific bindingproteins are described in U.S. Pat. Nos. 5,498,538, 5,432,018, and WO98/15833.

Methods of generating peptide libraries and screening these librariesare also disclosed in U.S. Pat. Nos. 5,723,286, 5,432,018, 5,580,717,5,427,908, 5,498,530, 5,770,434, 5,734,018, 5,698,426, 5,763,192, and5,723,323.

D. Binding Small Molecules

Provided herein are binding small molecules for use as a PD-L1 smallmolecule antagonist.

Binding small molecules are preferably organic molecules other thanbinding polypeptides or antibodies as defined herein that bind,preferably specifically, to PD-L1 as described herein. Binding organicsmall molecules may be identified and chemically synthesized using knownmethodology (see, e.g., PCT Publication Nos. WO 00/00823 and WO00/39585). Binding organic small molecules are usually less than about2000 daltons in size, alternatively less than about 1500, 750, 500, 250or 200 daltons in size, wherein such organic small molecules that arecapable of binding, preferably specifically, to a polypeptide asdescribed herein may be identified without undue experimentation usingwell known techniques. In this regard, it is noted that techniques forscreening organic small molecule libraries for molecules that arecapable of binding to a polypeptide target are well known in the art(see, e.g., PCT Publication Nos. WO 00/00823 and WO 00/39585). Bindingorganic small molecules may be, for example, aldehydes, ketones, oximes,hydrazones, semicarbazones, carbazides, primary amines, secondaryamines, tertiary amines, N-substituted hydrazines, hydrazides, alcohols,ethers, thiols, thioethers, disulfides, carboxylic acids, esters,amides, ureas, carbamates, carbonates, ketals, thioketals, acetals,thioacetals, aryl halides, aryl sulfonates, alkyl halides, alkylsulfonates, aromatic compounds, heterocyclic compounds, anilines,alkenes, alkynes, diols, amino alcohols, oxazolidines, oxazolines,thiazolidines, thiazolines, enamines, sulfonamides, epoxides,aziridines, isocyanates, sulfonyl chlorides, diazo compounds, acidchlorides, or the like.

E. Antagonist Polynucleotides

Provided herein are polynucleotide antagonists. The polynucleotide maybe an antisense nucleic acid and/or a ribozyme. The antisense nucleicacids comprise a sequence complementary to at least a portion of an RNAtranscript of a PD-L1 gene. However, absolute complementarity, althoughpreferred, is not required.

A sequence “complementary to at least a portion of an RNA,” referred toherein, means a sequence having sufficient complementarity to be able tohybridize with the RNA, forming a stable duplex; in the case of doublestranded PD-L1 antisense nucleic acids, a single strand of the duplexDNA may thus be tested, or triplex formation may be assayed. The abilityto hybridize will depend on both the degree of complementarity and thelength of the antisense nucleic acid. Generally, the larger thehybridizing nucleic acid, the more base mismatches with an PD-L1 RNA itmay contain and still form a stable duplex (or triplex as the case maybe). One skilled in the art can ascertain a tolerable degree of mismatchby use of standard procedures to determine the melting point of thehybridized complex.

Polynucleotides that are complementary to the 5′ end of the message,e.g., the 5′ untranslated sequence up to and including the AUGinitiation codon, should work most efficiently at inhibitingtranslation. However, sequences complementary to the 3′ untranslatedsequences of mRNAs have been shown to be effective at inhibitingtranslation of mRNAs as well. See generally, Wagner, R., 1994, Nature372:333-335. Thus, oligonucleotides complementary to either the 5′- or3′-non-translated, non-coding regions of the PD-L1 gene, could be usedin an antisense approach to inhibit translation of endogenous PD-L1mRNA. Polynucleotides complementary to the 5′ untranslated region of themRNA should include the complement of the AUG start codon. Antisensepolynucleotides complementary to mRNA coding regions are less efficientinhibitors of translation but could be used in accordance with theinvention. Whether designed to hybridize to the 5′-, 3′- or codingregion of PD-L1 mRNA, antisense nucleic acids should be at least sixnucleotides in length, and are preferably oligonucleotides ranging from6 to about 50 nucleotides in length. In specific embodiments theoligonucleotide is at least 10 nucleotides, at least 17 nucleotides, atleast 25 nucleotides or at least 50 nucleotides.

In one embodiment, the PD-L1 antisense nucleic acid is producedintracellularly by transcription from an exogenous sequence. Forexample, a vector or a portion thereof, is transcribed, producing anantisense nucleic acid (RNA) of the PD-L1 gene. Such a vector wouldcontain a sequence encoding the PD-L1 antisense nucleic acid. Such avector can remain episomal or become chromosomally integrated, as longas it can be transcribed to produce the desired antisense RNA. Suchvectors can be constructed by recombinant DNA technology methodsstandard in the art. Vectors can be plasmid, viral, or others know inthe art, used for replication and expression in vertebrate cells.Expression of the sequence encoding PD-L1, or fragments thereof, can beby any promoter known in the art to act in vertebrate, preferably humancells. Such promoters can be inducible or constitutive. Such promotersinclude, but are not limited to, the SV40 early promoter region(Bernoist and Chambon, Nature 29:304-310 (1981), the promoter containedin the 3′ long terminal repeat of Rous sarcoma virus (Yamamoto et al.,Cell 22:787-797 (1980), the herpes thymidine promoter (Wagner et al.,Proc. Natl. Acad. Sci. U.S.A. 78:1441-1445 (1981), the regulatorysequences of the metallothionein gene (Brinster, et al., Nature296:39-42 (1982)), etc.

F. Antibody and Binding Polypeptide Variants

In certain embodiments, amino acid sequence variants of the antibodiesand/or the binding polypeptides provided herein are contemplated. Forexample, it may be desirable to improve the binding affinity and/orother biological properties of the antibody and/or binding polypeptide.Amino acid sequence variants of an antibody and/or binding polypeptidesmay be prepared by introducing appropriate modifications into thenucleotide sequence encoding the antibody and/or binding polypeptide, orby peptide synthesis. Such modifications include, for example, deletionsfrom, and/or insertions into and/or substitutions of residues within theamino acid sequences of the antibody and/or binding polypeptide. Anycombination of deletion, insertion, and substitution can be made toarrive at the final construct, provided that the final constructpossesses the desired characteristics, e.g., target-binding.

In certain embodiments, antibody variants and/or binding polypeptidevariants having one or more amino acid substitutions are provided. Sitesof interest for substitutional mutagenesis include the HVRs and FRs.Conservative substitutions are shown in Table 1 under the heading of“conservative substitutions.” More substantial changes are provided inTable 1 under the heading of “exemplary substitutions,” and as furtherdescribed below in reference to amino acid side chain classes. Aminoacid substitutions may be introduced into an antibody and/or bindingpolypeptide of interest and the products screened for a desiredactivity, e.g., retained/improved antigen binding, decreasedimmunogenicity, or improved ADCC or CDC.

TABLE 1 Original Preferred Residue Exemplary Substitutions SubstitutionsAla (A) Val; Leu; Ile Val Arg (R) Lys; Gln; Asn Lys Asn (N) Gln; His;Asp, Lys; Arg Gln Asp (D) Glu; Asn Glu Cys (C) Ser; Ala Ser Gln (Q) Asn;Glu Asn Glu (E) Asp; Gln Asp Gly (G) Ala Ala His (H) Asn; Gln; Lys; ArgArg Ile (I) Leu; Val; Met; Ala; Phe; Leu Norleucine Leu (L) Norleucine;Ile; Val; Met; Ala; Phe Ile Lys (K) Arg; Gln; Asn Arg Met (M) Leu; Phe;Ile Leu Phe (F) Trp; Leu; Val; Ile; Ala; Tyr Tyr Pro (P) Ala Ala Ser (S)Thr Thr Thr (T) Val; Ser Ser Trp (W) Tyr; Phe Tyr Tyr (Y) Trp; Phe; Thr;Ser Phe Val (V) Ile; Leu; Met; Phe; Ala; Norleucine Leu

Amino acids may be grouped according to common side-chain properties:

(1) hydrophobic: Norleucine, Met, Ala, Val, Leu, Ile;

(2) neutral hydrophilic: Cys, Ser, Thr, Asn, Gln;

(3) acidic: Asp, Glu;

(4) basic: His, Lys, Arg;

(5) residues that influence chain orientation: Gly, Pro;

(6) aromatic: Tip, Tyr, Phe.

Non-conservative substitutions will entail exchanging a member of one ofthese classes for another class.

One type of substitutional variant involves substituting one or morehypervariable region residues of a parent antibody (e.g., a humanized orhuman antibody). Generally, the resulting variant(s) selected forfurther study will have modifications (e.g., improvements) in certainbiological properties (e.g., increased affinity, reduced immunogenicity)relative to the parent antibody and/or will have substantially retainedcertain biological properties of the parent antibody. An exemplarysubstitutional variant is an affinity matured antibody, which may beconveniently generated, e.g., using phage display-based affinitymaturation techniques such as those described herein. Briefly, one ormore HVR residues are mutated and the variant antibodies displayed onphage and screened for a particular biological activity (e.g., bindingaffinity).

Alterations (e.g., substitutions) may be made in HVRs, e.g., to improveantibody affinity. Such alterations may be made in HVR “hotspots,” i.e.,residues encoded by codons that undergo mutation at high frequencyduring the somatic maturation process (see, e.g., Chowdhury, MethodsMol. Biol. 207:179-196 (2008)), and/or SDRs (a-CDRs), with the resultingvariant VH or VL being tested for binding affinity. Affinity maturationby constructing and reselecting from secondary libraries has beendescribed, e.g., in Hoogenboom et al. in Methods in Molecular Biology178:1-37 (O'Brien et al., ed., Human Press, Totowa, N.J., (2001).) Insome embodiments of affinity maturation, diversity is introduced intothe variable genes chosen for maturation by any of a variety of methods(e.g., error-prone PCR, chain shuffling, or oligonucleotide-directedmutagenesis). A secondary library is then created. The library is thenscreened to identify any antibody variants with the desired affinity.Another method to introduce diversity involves HVR-directed approaches,in which several HVR residues (e.g., 4-6 residues at a time) arerandomized. HVR residues involved in antigen binding may be specificallyidentified, e.g., using alanine scanning mutagenesis or modeling. CDR-H3and CDR-L3 in particular are often targeted.

In certain embodiments, substitutions, insertions, or deletions mayoccur within one or more HVRs so long as such alterations do notsubstantially reduce the ability of the antibody to bind antigen. Forexample, conservative alterations (e.g., conservative substitutions asprovided herein) that do not substantially reduce binding affinity maybe made in HVRs. Such alterations may be outside of HVR “hotspots” orSDRs. In certain embodiments of the variant VH and VL sequences providedabove, each HVR either is unaltered, or contains no more than one, twoor three amino acid substitutions.

A useful method for identification of residues or regions of theantibody and/or the binding polypeptide that may be targeted formutagenesis is called “alanine scanning mutagenesis” as described byCunningham and Wells (1989) Science, 244:1081-1085. In this method, aresidue or group of target residues (e.g., charged residues such as arg,asp, his, lys, and glu) are identified and replaced by a neutral ornegatively charged amino acid (e.g., alanine or polyalanine) todetermine whether the interaction of the antibody with antigen isaffected. Further substitutions may be introduced at the amino acidlocations demonstrating functional sensitivity to the initialsubstitutions. Alternatively, or additionally, a crystal structure of anantigen-antibody complex to identify contact Points between the antibodyand antigen. Such contact residues and neighboring residues may betargeted or eliminated as candidates for substitution. Variants may bescreened to determine whether they contain the desired properties.

Amino acid sequence insertions include amino- and/or carboxyl-terminalfusions ranging in length from one residue to polypeptides containing ahundred or more residues, as well as intrasequence insertions of singleor multiple amino acid residues. Examples of terminal insertions includean antibody with an N-terminal methionyl residue. Other insertionalvariants of the antibody molecule include the fusion to the N- orC-terminus of the antibody to an enzyme (e.g., for ADEPT) or apolypeptide which increases the serum half-life of the antibody.

G. Antibody and Binding Polypeptide Derivatives

In certain embodiments, an antibody and/or binding polypeptide providedherein may be further modified to contain additional nonproteinaceousmoieties that are known in the art and readily available. The moietiessuitable for derivatization of the antibody and/or binding polypeptideinclude but are not limited to water soluble polymers. Non-limitingexamples of water soluble polymers include, but are not limited to,polyethylene glycol (PEG), copolymers of ethylene glycol/propyleneglycol, carboxymethylcellulose, dextran, polyvinyl alcohol, polyvinylpyrrolidone, poly-1,3-dioxolane, poly-1,3,6-trioxane, ethylene/maleicanhydride copolymer, polyaminoacids (either homopolymers or randomcopolymers), and dextran or poly(n-vinyl pyrrolidone)polyethyleneglycol, propropylene glycol homopolymers, prolypropylene oxide/ethyleneoxide co-polymers, polyoxyethylated polyols (e.g., glycerol), polyvinylalcohol, and mixtures thereof. Polyethylene glycol propionaldehyde mayhave advantages in manufacturing due to its stability in water. Thepolymer may be of any molecular weight, and may be branched orunbranched. The number of polymers attached to the antibody and/orbinding polypeptide may vary, and if more than one polymer are attached,they can be the same or different molecules. In general, the numberand/or type of polymers used for derivatization can be determined basedon considerations including, but not limited to, the particularproperties or functions of the antibody and/or binding polypeptide to beimproved, whether the antibody derivative and/or binding polypeptidederivative will be used in a therapy under defined conditions, etc.

In another embodiment, conjugates of an antibody and/or bindingpolypeptide to nonproteinaceous moiety that may be selectively heated byexposure to radiation are provided. In one embodiment, thenonproteinaceous moiety is a carbon nanotube (Kam et al., Proc. Natl.Acad. Sci. USA 102: 11600-11605 (2005)). The radiation may be of anywavelength, and includes, but is not limited to, wavelengths that do notharm ordinary cells, but which heat the nonproteinaceous moiety to atemperature at which cells proximal to the antibody and/or bindingpolypeptide-nonproteinaceous moiety are killed.

In some embodiments, the sample is a tissue sample. In some embodiments,the sample is a tumor tissue sample. In some embodiments, the tumortissue sample comprises tumor cells, tumor infiltrating immune cells,intratumoral immune cells, peritumoral immune cells or any combinationsthereof, tumor stroma cells (e.g. fibroblasts). In some embodiments, thesample is of a patient's cancer. In some embodiments, the sample isobtained prior to treatment with a PD-L1 axis binding antagonist. Insome embodiments, the sample is formalin fixed and paraffin embedded.

In some embodiments, the disease or disorder is a proliferative diseaseor disorder. In some embodiments, the disease or disorder is animmune-related disease or disorder. In some embodiments, the disease ordisorder is cancer. In some embodiments, the cancer is non-small celllung cancer, renal cell cancer, ovarian cancer, pancreatic cancer,gastric carcinoma, bladder cancer, esophageal cancer, mesothelioma,melanoma, breast cancer, thyroid cancer, colorectal cancer, head andneck cancer, osteosarcoma, prostate cancer, or glioblastoma. In someembodiments, the cancer is non-small cell lung cancer (NSCLC). In someembodiments, the NSCLC is second-line or third-line locally advanced ormetastatic NSCLC. In some embodiments, the NSCLC is adenocarcinoma. Insome embodiments, the NSCLC is squamous cell carcinoma.

In some embodiments of any of the methods, the individual according toany of the above embodiments may be a human.

In a further embodiment, provided herein are methods for treating acancer. In one embodiment, the method comprises administering to anindividual having such cancer an effective amount of a PD-L1 axisbinding antagonist. In one such embodiment, the method further comprisesadministering to the individual an effective amount of at least oneadditional therapeutic agent. In some embodiments, the individual may bea human.

PD-L1 axis binding antagonist described herein can be used either aloneor in combination with other agents in a therapy. For instance, a PD-L1axis binding antagonist described herein may be co-administered with atleast one additional therapeutic agent. In certain embodiments, anadditional therapeutic agent is a chemotherapeutic agent.

Such combination therapies noted above encompass combined administration(where two or more therapeutic agents are included in the same orseparate formulations), and separate administration, in which case,administration of the antagonist can occur prior to, simultaneously,and/or following, administration of the additional therapeutic agentand/or adjuvant. PD-L1 axis binding antagonist described herein can alsobe used in combination with radiation therapy.

A PD-L1 axis binding antagonist (e.g., an antibody, binding polypeptide,and/or small molecule) described herein (and any additional therapeuticagent) can be administered by any suitable means, including parenteral,intrapulmonary, and intranasal, and, if desired for local treatment,intralesional administration. Parenteral infusions includeintramuscular, intravenous, intraarterial, intraperitoneal, orsubcutaneous administration. Dosing can be by any suitable route, e.g.,by injections, such as intravenous or subcutaneous injections, dependingin part on whether the administration is brief or chronic. Variousdosing schedules including but not limited to single or multipleadministrations over various time-points, bolus administration, andpulse infusion are contemplated herein.

PD-L1 axis binding antagonists (e.g., an antibody, binding polypeptide,and/or small molecule) described herein may be formulated, dosed, andadministered in a fashion consistent with good medical practice. Factorsfor consideration in this context include the particular disorder beingtreated, the particular mammal being treated, the clinical condition ofthe individual patient, the cause of the disorder, the site of deliveryof the agent, the method of administration, the scheduling ofadministration, and other factors known to medical practitioners. ThePD-L1 axis antagonist need not be, but is optionally formulated with oneor more agents currently used to prevent or treat the disorder inquestion. The effective amount of such other agents depends on theamount of the PD-L1 axis binding antagonist present in the formulation,the type of disorder or treatment, and other factors discussed above.These are generally used in the same dosages and with administrationroutes as described herein, or about from 1 to 99% of the dosagesdescribed herein, or in any dosage and by any route that isempirically/clinically determined to be appropriate.

For the prevention or treatment of disease, the appropriate dosage of aPD-L1 axis binding antagonist described herein (when used alone or incombination with one or more other additional therapeutic agents) willdepend on the type of disease to be treated, the severity and course ofthe disease, whether the PD-L1 axis binding antagonist is administeredfor preventive or therapeutic purposes, previous therapy, the patient'sclinical history and response to the PD-L1 axis binding antagonist, andthe discretion of the attending physician. The PD-L1 axis bindingantagonist is suitably administered to the patient at one time or over aseries of treatments. One typical daily dosage might range from about 1μg/kg to 100 mg/kg or more, depending on the factors mentioned above.For repeated administrations over several days or longer, depending onthe condition, the treatment would generally be sustained until adesired suppression of disease symptoms occurs. Such doses may beadministered intermittently, e.g., every week or every three weeks(e.g., such that the patient receives from about two to about twenty, ore.g., about six doses of the PD-L1 axis binding antagonist). An initialhigher loading dose, followed by one or more lower doses may beadministered. An exemplary dosing regimen comprises administering.However, other dosage regimens may be useful. The progress of thistherapy is easily monitored by conventional techniques and assays.

In some embodiments of any of the methods, the PD-L1 axis bindingantagonist (e.g., anti-PD-L1 antibody) is administered at a dosage ofabout 0.3-30 mg/kg. In some embodiments, the PD-L1 axis bindingantagonist (e.g., anti-PD-L1 antibody) is administered at a dosage ofabout any of 0.3 mg/kg, 0.5 mg/kg, 1 mg/kg, 2 mg/kg, 4 mg/kg, 8 mg/kg,15 mg/kg, 20 mg/kg, or 30 mg/kg. In some embodiments, the PD-L1 axisbinding antagonist (e.g., anti-PD-L1 antibody) is administered at adosage of about any of 2 mg/kg, 4 mg/kg, 8 mg/kg, 15 mg/kg, or 30 mg/kgin 21-day cycles. It is understood that any of the above formulations ortherapeutic methods may be carried out using an immunoconjugate in placeof or in addition to the PD-L1 axis binding antagonist.

Pharmaceutical formulations of a PD-L1 axis binding antagonist asdescribed herein are prepared by mixing such antibody having the desireddegree of purity with one or more optional pharmaceutically acceptablecarriers (Remington's Pharmaceutical Sciences 16th edition, Osol, A. Ed.(1980)), in the form of lyophilized formulations or aqueous solutions.In some embodiments, the PD-L1 axis binding antagonist is a bindingsmall molecule, an antibody, binding polypeptide, and/or polynucleotide.Pharmaceutically acceptable carriers are generally nontoxic torecipients at the dosages and concentrations employed, and include, butare not limited to: buffers such as phosphate, citrate, and otherorganic acids; antioxidants including ascorbic acid and methionine;preservatives (such as octadecyldimethylbenzyl ammonium chloride;hexamethonium chloride; benzalkonium chloride; benzethonium chloride;phenol, butyl or benzyl alcohol; alkyl parabens such as methyl or propylparaben; catechol; resorcinol; cyclohexanol; 3-pentanol; and m-cresol);low molecular weight (less than about 10 residues) polypeptides;proteins, such as serum albumin, gelatin, or immunoglobulins;hydrophilic polymers such as polyvinylpyrrolidone; amino acids such asglycine, glutamine, asparagine, histidine, arginine, or lysine;monosaccharides, disaccharides, and other carbohydrates includingglucose, mannose, or dextrins; chelating agents such as EDTA; sugarssuch as sucrose, mannitol, trehalose or sorbitol; salt-formingcounter-ions such as sodium; metal complexes (e.g., Zn-proteincomplexes); and/or non-ionic surfactants such as polyethylene glycol(PEG). Exemplary pharmaceutically acceptable carriers herein furtherinclude insterstitial drug dispersion agents such as solubleneutral-active hyaluronidase glycoproteins (sHASEGP), for example, humansoluble PH-20 hyaluronidase glycoproteins, such as rHuPH20 (HYLENEX®,Baxter International, Inc.). Certain exemplary sHASEGPs and methods ofuse, including rHuPH20, are described in US Patent Publication Nos.2005/0260186 and 2006/0104968. In one embodiment, a sHASEGP is combinedwith one or more additional glycosaminoglycanases such aschondroitinases.

Exemplary lyophilized formulations are described in U.S. Pat. No.6,267,958. Aqueous antibody formulations include those described in U.S.Pat. No. 6,171,586 and WO 2006/044908, the latter formulations includinga histidine-acetate buffer.

The formulation herein may also contain more than one active ingredientsas necessary for the particular indication being treated, preferablythose with complementary activities that do not adversely affect eachother. Such active ingredients are suitably present in combination inamounts that are effective for the purpose intended.

Active ingredients may be entrapped in microcapsules prepared, forexample, by coacervation techniques or by interfacial polymerization,for example, hydroxymethylcellulose or gelatin-microcapsules andpoly-(methylmethacylate) microcapsules, respectively, in colloidal drugdelivery systems (for example, liposomes, albumin microspheres,microemulsions, nano-particles and nanocapsules) or in macroemulsions.Such techniques are disclosed in Remington's Pharmaceutical Sciences16th edition, Osol, A. Ed. (1980).

Sustained-release preparations may be prepared. Suitable examples ofsustained-release preparations include semipermeable matrices of solidhydrophobic polymers containing the PD-L1 axis binding antagonist, whichmatrices are in the form of shaped articles, e.g., films, ormicrocapsules.

The formulations to be used for in vivo administration are generallysterile. Sterility may be readily accomplished, e.g., by filtrationthrough sterile filtration membranes.

It is understood that any of the above articles of manufacture mayinclude an immunoconjugate described herein in place of or in additionto a PD-L1 antagonist.

Identifying and Methods of Using Biomarkers

Provided herein are methods for identifying treatment-responsivebiomarkers.

In some embodiments, pharmacodynamics biomarkers can be identified basedon a correlation or the defined relationship between analyte expressionlevels and positive or negative changes in a subject's response relativeto one or more pre-treatment baseline response. In some embodiments,analyte expression levels can be measured in samples collected from asubject prior to, during and following treatment or therapeuticintervention.

Pharmacodynamic biomarkers can be used for, without limitation,treatment monitoring and assessing treatment effectiveness. For example,pharmacodynamics biomarker levels can be provided to a clinician for usein establishing or altering a course of treatment for a subject. When atreatment is selected and treatment starts, the subject can be monitoredperiodically by collecting biological samples at two or more intervals,determining a clinical response corresponding to a given time intervalpre-, during, and post-treatment, and comparing clinical response overtime. On the basis of these responses and any trends observed withrespect to increasing, decreasing or stabilizing clinical responses orchanges in pharmacodynamics biomarker levels, a clinician, therapist, orother health-care professional may choose to continue treatment as is,to discontinue treatment, or to adjust the treatment plan with the goalof seeing improvement over time.

Accordingly, provided herein are methods for assessing a treatmentresponse of an individual with a PD-L1 axis binding antagonist, themethod comprising: (a) determining the level(s) of one or morebiomarkers in a biological sample derived from the individual at a timepoint during or after administration of the PD-L1 axis bindingantagonist; and (b) maintaining, adjusting, or stopping the treatment ofthe individual based on a comparison of the level(s) of one or morebiomarkers in the biological sample with reference levels, wherein achange in the level(s) of one or more biomarkers in the biologicalsample compared to the reference levels is indicative of a response totreatment with the PD-L1 axis binding antagonist.

Further provided herein are methods for monitoring the response of anindividual treated with a PD-L1 axis binding antagonist, said methodcomprising: (a) determining the level(s) of one or more biomarkers in abiological sample derived from the individual at a time point during orafter administration of the PD-L1 axis binding antagonist; and (b)comparing the level(s) of one or more biomarkers in the biologicalsample with reference levels in order to monitor the response in theindividuals undergoing treatment with the PD-L1 axis binding antagonist.

In some embodiments, the reference levels of the one or more biomarkersis selected from the group consisting of (1) the level of the one ormore biomarkers from the individual prior to administration of the PD-L1axis binding antagonist; (2) the level of the one or more biomarkersfrom a reference population; (3) a pre-assigned level for the one ormore biomarkers; and (4) the level of the one or more biomarkers fromthe individual at a second time point prior to the first time point.

To correlate and compare an individual's biological sample with areference population, it is necessary to obtain data on the clinicalresponses exhibited by a population of individuals who received thetreatment, i.e., a clinical population, before and/or after treatmentwith the PD-L1 axis binding antagonist. This clinical data may beobtained by retrospective analysis of the results of a clinicaltrial(s). Alternatively, the clinical data may be obtained by designingand carrying out one or more new clinical trials. The analysis ofclinical population data is useful to define a standard referencepopulation which, in turn, is useful to classify subjects for selectionof therapeutic treatment, and/or to classify subjects as exhibiting apositive response to treatment with a PD-L1 axis binding antagonist.

In some embodiments, the change in the level(s) of one or morebiomarkers in the biological sample compared to the reference levels isan increase in the levels.

In some embodiments, the change in the level(s) of one or morebiomarkers in the biological sample compared to the reference levels isa decrease in the levels.

In some embodiments, the one or more biomarkers is selected from thegroup consisting of PD-L1, PD-1, PD-L2 and any combinations thereof. Insome embodiments, an increase in one or more biomarkers selected fromthe group consisting of PD-L1, PD-1, PD-L2 and any combinations thereofin the biological sample compared to the reference levels is indicativeof a positive response to treatment.

In some embodiments, the one or more biomarkers is an immune relatedmarker.

In some embodiments, the one or more biomarkers is a T-cell relatedmarker.

In some embodiments, the one or more biomarkers is a T-cell activationmarker.

In some embodiments, the T-cell activation marker is increased in thebiological sample compared to the reference levels.

In some embodiments, the T-cell activation marker is selected from thegroup consisting of an CD8, IFN-g, Granzyme-A, TNF-a, perforin and anycombinations thereof. In some embodiments, an increase in the T-cellactivation marker selected from the group consisting of CD8, IFN-g,Granzyme-A, TNF-a, perforin and any combinations thereof in thebiological sample compared to the reference levels is indicative of apositive response to treatment.

In some embodiments, the one or more biomarkers is an activatedproliferating T cell.

In some embodiments, the activated proliferating T cell is increased inthe biological sample compared to the reference levels.

In some embodiments, the activated proliferating T cell is a CD8+/Ki67+cell, CD8+/HLA-DR+/Ki67+ cell and any combinations thereof.

In some embodiments, the one or more biomarkers is IL-6.

In some embodiments, the IL-6 level is decreased in the biologicalsample compared to the reference levels. In some embodiments, a decreasein the IL-6 level in the biological sample compared to the referencelevels is indicative of a positive response to treatment. In someembodiments, the IL-6 level is increased in the biological samplecompared to the reference levels. In some embodiments, an increase inthe IL-6 level in the biological sample compared to the reference levelsindicates that there is no response to treatment.

In some embodiments, the biological sample derived from the individualis selected from the group consisting of a cell, a tissue, a tissueculture, a tumor, a biological fluid and combinations thereof.

In some embodiments, the biological fluid is selected from the groupconsisting of plasma, serum, whole blood, PBMCs and combinationsthereof.

In some embodiments, the tissue is a tumor tissue.

In some embodiments, the tumor tissue is selected from the groupconsisting of tumor cells, tumor infiltrating cells, stromal cells andany combinations thereof.

In some embodiments, the cell is a circulating tumor cell (CTC).

In some embodiments, the individual suffers from a proliferative diseaseor disorder.

In some embodiments, the individual suffers from cancer or malignancy.

In some embodiments, the cancer or malignancy is selected from non-smallcell lung cancer, small cell lung cancer, renal cell cancer, colorectalcancer, ovarian cancer, breast cancer, pancreatic cancer, gastriccarcinoma, bladder cancer, esophageal cancer, mesothelioma, melanoma,head and neck cancer, thyroid cancer, sarcoma, prostate cancer,glioblastoma, cervical cancer, thymic carcinoma, leukemia, lymphomas,myelomas, mycoses fungoids, merkel cell cancer, and other hematologicmalignancies.

In some embodiments, the individual suffers from an immune-relateddisease or disorder.

In some embodiments, the PD-L1 axis binding antagonist is a PD-L1binding antagonist.

In some embodiments, the PD-L1 binding antagonist inhibits the bindingof PD-L1 to its ligand binding partners.

In some embodiments, the PD-L1 binding antagonist inhibits the bindingof PD-L1 to PD-1.

In some embodiments, the PD-L1 binding antagonist inhibits the bindingof PD-L1 to B7-1.

In some embodiments, the PD-L1 binding antagonist inhibits the bindingof PD-L1 to both PD-1 and B7-1.

In some embodiments, the PD-L1 binding antagonist is an antibody.

In some embodiments, the antibody is a monoclonal antibody.

In some embodiments, the antibody is a human, humanized or chimericantibody.

In some embodiments, the PD-L1 axis binding antagonist is a PD-1 bindingantagonist.

In some embodiments, the PD-1 binding antagonist inhibits the binding ofPD-1 to its ligand binding partners.

In some embodiments, the PD-1 binding antagonist inhibits the binding ofPD-1 to PD-L1.

In some embodiments, the PD-1 binding antagonist inhibits the binding ofPD-1 to PD-L2.

In some embodiments, the PD-1 binding antagonist inhibits the binding ofPD-1 to both PD-L1 and PD-L2.

In some embodiments, the PD-1 binding antagonist is an antibody.

In some embodiments, the antibody is a monoclonal antibody.

In some embodiments, the antibody is a human, humanized or chimericantibody.

Methods of Advertising

Further provided herein are methods for advertising a PD-L1 axis bindingantagonist comprising promoting, to a target audience, the use of thePD-L1 axis binding antagonist for treating an individual with a diseaseor disorder based on presence and/or levels of a PD-L1 biomarker. Insome embodiments, the use of the PD-L1 axis binding antagonist is basedupon elevated levels of the PD-L1 biomarker.

Advertising is generally paid communication through a non-personalmedium in which the sponsor is identified and the message is controlled.Advertising for purposes herein includes publicity, public relations,product placement, sponsorship, underwriting, and sales promotion. Thisterm also includes sponsored informational public notices appearing inany of the print communications media designed to appeal to a massaudience to persuade, inform, promote, motivate, or otherwise modifybehavior toward a favorable pattern of purchasing, supporting, orapproving the invention herein.

The advertising and promotion of the diagnostic method herein may beaccomplished by any means. Examples of advertising media used to deliverthese messages include television, radio, movies, magazines, newspapers,the internet, and billboards, including commercials, which are messagesappearing in the broadcast media. Advertisements also include those onthe seats of grocery carts, on the walls of an airport walkway, and onthe sides of buses, or heard in telephone hold messages or in-store PAsystems, or anywhere a visual or audible communication can be placed.

More specific examples of promotion or advertising means includetelevision, radio, movies, the internet such as webcasts and webinars,interactive computer networks intended to reach simultaneous users,fixed or electronic billboards and other public signs, posters,traditional or electronic literature such as magazines and newspapers,other media outlets, presentations or individual contacts by, e.g.,e-mail, phone, instant message, postal, courier, mass, or carrier mail,in-person visits, etc.

The type of advertising used will depend on many factors, for example,on the nature of the target audience to be reached, e.g., hospitals,insurance companies, clinics, doctors, nurses, and patients, as well ascost considerations and the relevant jurisdictional laws and regulationsgoverning advertising of medicaments and diagnostics. The advertisingmay be individualized or customized based on user characterizationsdefined by service interaction and/or other data such as userdemographics and geographical location.

Diagnostic Kits, Assays and Articles of Manufacture

Provided herein are diagnostic kit comprising one or more reagent fordetermining the presence of a PD-L1 biomarker in a sample from anindividual with a disease or disorder, wherein the presence of a PD-L1biomarker means a higher likelihood of efficacy when the individual istreated with a PD-L1 axis binding antagonist, and wherein the absence ofa PD-L1 biomarker means a less likelihood of efficacy when theindividual with the disease is treated with the PD-L1 axis bindingantagonist. Optionally, the kit further comprises instructions to usethe kit to select a medicament (e.g. a PD-L1 axis binding antagonist,such as an anti-PD-L1 antibody) for treating the disease or disorder ifthe individual expresses the PD-L1 biomarker. In another embodiment, theinstructions are to use the kit to select a medicament other than PD-L1axis binding antagonist if the individual does not express the PD-L1biomarker.

Provided herein are also assay for identifying an individual with adisease or disorder to receive a PD-L1 axis binding antagonist, themethod comprising: determining the presence of a PD-L1 biomarker in asample from the individual, and recommending a PD-L1 axis bindingantagonist based on the presence of a PD-L1 biomarker.

Provided herein are also articles of manufacture comprising, packagedtogether, a PD-L1 axis binding antagonist (e.g., anti-PD-L1 antibodies)in a pharmaceutically acceptable carrier and a package insert indicatingthat the PD-L1 axis binding antagonist (e.g., anti-PD-L1 antibodies) isfor treating a patient with a disease or disorder based on expression ofa PD-L1 biomarker. Treatment methods include any of the treatmentmethods disclosed herein. Further provided are the invention concerns amethod for manufacturing an article of manufacture comprising combiningin a package a pharmaceutical composition comprising a PD-L1 axisbinding antagonist (e.g., anti-PD-L1 antibodies) and a package insertindicating that the pharmaceutical composition is for treating a patientwith a disease or disorder based on expression of PD-L1 biomarker.

The article of manufacture comprises a container and a label or packageinsert on or associated with the container. Suitable containers include,for example, bottles, vials, syringes, etc. The containers may be formedfrom a variety of materials such as glass or plastic. The containerholds or contains a composition comprising the cancer medicament as theactive agent and may have a sterile access port (for example thecontainer may be an intravenous solution bag or a vial having a stopperpierceable by a hypodermic injection needle).

The article of manufacture may further comprise a second containercomprising a pharmaceutically-acceptable diluent buffer, such asbacteriostatic water for injection (BWFI), phosphate-buffered saline,Ringer's solution and dextrose solution. The article of manufacture mayfurther include other materials desirable from a commercial and userstandpoint, including other buffers, diluents, filters, needles, andsyringes.

The article of manufacture of the present invention also includesinformation, for example in the form of a package insert, indicatingthat the composition is used for treating cancer based on expressionlevel of the biomarker(s) herein. The insert or label may take any form,such as paper or on electronic media such as a magnetically recordedmedium (e.g., floppy disk) or a CD-ROM. The label or insert may alsoinclude other information concerning the pharmaceutical compositions anddosage forms in the kit or article of manufacture.

The invention also concerns a method for manufacturing an article ofmanufacture comprising combining in a package a pharmaceuticalcomposition comprising a PD-L1 axis binding antagonist (e.g., ananti-PD-L1 antibody) and a package insert indicating that thepharmaceutical composition is for treating a patient with cancer (suchas NSCLC) based on expression of a PD-L1 biomarker.

The article of manufacture may further comprise an additional containercomprising a pharmaceutically acceptable diluent buffer, such asbacteriostatic water for injection (BWFI), phosphate-buffered saline,Ringer's solution, and/or dextrose solution. The article of manufacturemay further include other materials desirable from a commercial and userstandpoint, including other buffers, diluents, filters, needles, andsyringes.

EXAMPLES

The following are examples of methods and compositions. It is understoodthat various other embodiments may be practiced, given the generaldescription provided above.

Materials and Methods for Examples

Samples: Formalin-fixed paraffin-embedded (FFPE) sections of a tumorsample or cancer cell line were analyzed.

Immunohistochemistry (IHC): Formalin-fixed, paraffin-embedded tissuesections were deparaffinized prior to antigen retrieval, blocking andincubation with primary anti-PD-L1 antibodies. Following incubation withsecondary antibody and enzymatic color development, sections werecounterstained and dehydrated in series of alcohols and xylenes beforecoverslipping.

The following protocol was used for IHC. The Ventana Benchmark XT orBenchmark Ultra system was used to perform PD-L1IHC staining using thefollowing reagents and materials:

Primary antibody: anti-PD-L1 Rabbit Monoclonal Primary Antibody

Specimen Type: Formalin-fixed paraffin embedded (FFPE) section of tissuesamples and control cell pellets of varying staining intensities

Procedure Species: Human

Instrument: BenchMark XT or Benchmark Ultra

Epitope Recovery Conditions: Cell Conditioning, standard 1 (CC1,Ventana, cat #950-124)

Primary Antibody Conditions: 1/100, 6.5 μg/ml/16 minutes at 36° C.

Diluent: Antibody dilution buffer (Tris-buffered saline containingcarrier protein and Brig-35)

Negative control: Naive Rabbit IgG at 6.5 μg/ml (Cell Signaling) ordiluent alone

Detection: Optiview or Ultraview Universal DAB Detection kit (Ventana),and amplification kit (if applicable) were used according tomanufacturer's instructions (Ventana).

Counterstain: Ventana Hematoxylin II (cat #790-2208)/with Bluing reagent(Cat #760-2037) (4 minutes and 4 minutes, respectively)

The Benchmark Protocol was as follows:

1. paraffin (Selected)

2. Deparaffinization (Selected)

3. Cell Conditioning (Selected)

4. Conditioner #1 (Selected)

5. Standard CC1(Selected)

6. Ab Incubation Temperatures (Selected)

7. 36C Ab Inc. (Selected)

8. Titration (Selected)

9. Auto-dispense (Primary Antibody), and Incubate for (16 minutes)

10. Countstain (Selected)

11. Apply One Drop of (Hematoxylin II) (Countstain), Apply Coverslip,and Incubate for (4 minutes)

12. Post Counterstain (Selected)

13. Apply One Drop of (BLUING REAGENT) (Post Countstain), ApplyCoverslip, and Incubate for (4 minutes)

14. Wash slides in soap water to remove oil

15. Rinse slides with water

16. Dehydrate slides through 95% Ethanol, 100% Ethanol to xylene (Leicaautostainer program #9)

17. Cover slip.

Example 1 Scoring PD-L1 Expression by IHC

The presence or absence of PD-L1 expression in tumor specimens wasevaluated using anti-PD-L1-specific antibody that can detect PD-L1 inhuman formalin-fixed, paraffin-embedded (FFPE) tissues by IHC. Tomeasure and quantify relative expression of PD-L1 in tumor samples, aPD-L1 IHC scoring system was developed to measure PD-L1 specific signalin tumor cells and tumor infiltrating immune cells. Immune cells aredefined as cells with lymphoid and/or macrophage/histiocyte morphology.

Tumor cell staining is expressed as the percent of all tumor cellsshowing membranous staining of any intensity. Infiltrating immune cellstaining is defined as the percent of the total tumor area occupied byimmune cells that show staining of any intensity. The total tumor areaencompasses the malignant cells as well as tumor-associated stroma,including areas of immune infiltrates immediately adjacent to andcontiguous with the main tumor mass. In addition, infiltrating immunecell staining is defined as the percent of all tumor infiltrating immunecells.

There was a wide dynamic range of PD-L1 staining intensities in tumortissues. Irrespective of subcellular localization, the signal was alsoclassified as strong, moderate, weak, or negative staining.

As shown in FIG. 1, negative signal intensity is characterized by anabsence of any detectable signal, as illustrated using HEK-293 cells. Incontrast, positive signal intensity is characterized by a golden to darkbrown, membrane staining, as illustrated using HEK-293 cells transfectedwith recombinant human PD-L1. Finally, positive signal intensity is alsoillustrated by staining of placental trophoblasts and strong staining inthe area of tonsilar crypts and often in membranous pattern that ischaracterized by a golden to dark brown staining. In tumor tissues,PD-L1 negative samples are qualified as having no detectable signal oronly weak cytoplasmic background staining when evaluated using a 20×objective. In contrast, PD-L1 positive samples demonstrate primarilymembranous staining in tumor cells and/or infiltrating immune cells.PD-L1 staining is observed with variable intensity from weak with fine,light-brown membranes to strong with dark-brown thick membranes easilyrecognized at low magnification. As illustrated in FIG. 2, threerepresentative PD-L1 positive tumor samples are shown: (A)Triple-Negative Breast Cancer, in which most tumor cells are stronglypositive for PD-L1 showing a combination of membranous and cytoplasmicstaining (100× magnification); (B) Malignant Melanoma, in which acluster of immune cells, some of them with membranous staining forPD-L1, is shown; rare tumor cells (arrows) with membranous staining forPD-L1 (400× magnification); (C) NSCLC, adenocarcinoma, in which acluster of immune cells with strong staining for PD-L1 is shown; severaltumor cells (arrows) with membranous and/or cytoplasmic staining forPD-L1 (400× magnification).

The staining in positive cases tends to be focal with respect to spatialdistribution and intensity. The percentages of tumor or immune cellsshowing staining of any intensity were visually estimated and used todetermine PD-L1 status. An isotype negative control was used to evaluatethe presence of background in test samples.

Staining required one serial tissue section for H&E, a second serialtissue section for anti-PD-L1, and a third serial tissue section for theisotype negative control. The PD-L1-transfected HEK-293 cell linecontrol or tonsil slides were used as run controls and a reference forassay specificity.

PDL-1 Status Criteria

PD-L1 Status Staining criteria Negative 0% membrane staining orcytoplasmic staining or combinations of both at ANY staining intensityPositive >0% membrane staining or cytoplasmic staining or combinationsof both at ANY staining intensity ≥1% membrane staining or cytoplasmicstaining or combinations of both at ANY staining intensity ≥5% membranestaining or cytoplasmic staining or combinations of both at ANY stainingintensity ≥10% membrane staining or cytoplasmic staining or combinationsof both at ANY staining intensity

In some cases, the PD-L1 positive status may comprise the presence ofdiscernible PD-L1 staining of any intensity in either tumor cells ortumor infiltrating immune cells in u p to 50% of tumor area occupied bytumor cells, associated intratumoral, and contiguous peri-tumoraldesmoplastic stroma. Thus, PD-L1 positive staining includes as high as50% of tumor cells or tumor infiltrating immune cells showing stainingof any intensity.

Evaluable slides stained with anti-PD-L1 were evaluated as describedabove. Negative staining intensity was characterized by an absence ofany detectable signal or a signal that was characterized as pale gray toblue (rather than brown or tan) and absence of membrane enhancement. Thecase was negative if there were no (e.g., absent) membrane staining.

Example 2 Treatment Using Anti-PD-L1 Antibody

A Phase I study design specifically evaluated the correlation betweenPD-L1 tumor status as assessed by (a) an Anti-PD-L1 IHC reagent (b)PD-L1 gene expression as measured by a PD-L1 qPCR reagent (c) Immunegene signature as measured by a multiplex qPCR “immunochip” and clinicalbenefit of monotherapy inhibition of the PD-L1/PD-1 pathway as measuredby (i) RECIST 1.1 based responses (ii) immune-related Response Criteria(iii) PFS (iv) OS (v) complete response rate (vi) durability of response(vii) PD at 6 weeks. Patients in the expansion cohorts were required toprovide tumor tissue for assessment of PD-L1 tumor status, and wereenrolled into either expansion cohorts either regardless of PD-L1 tumorstatus, or enrolled into expansion cohorts which prospectively selectedpatients based on PD-L1 tumor status as measured by an IHC assay forPD-L1. Tumor types enrolled specifically included NSCLC (squamous andnon-squamous histology), melanoma, RCC, CRC, gastric cancer, breastcancer, SCCHN, pancreatic cancer, bladder cancer and hematologicmalignancies. Additionally, patients with lymphoma, myeloma, sarcoma,ovarian cancer, prostate cancer, esophageal cancer, small cell lungcancer, mycoses fungoides, merkel cell cancer, cervical cancer, HPV orEBV+SCCHN, and thymic carcinoma are/have also been enrolled.

In addition to assessing the correlation with baseline PD-L1 tumorstatus with clinical benefit from monotherapy inhibition of thePD-L1/PD-1 pathway, the study also evaluated the benefit of: (a)Measuring PD-L1 status in archival tumor samples vs fresh or recenttumor biopsy samples (b) evaluating CD8+ T cell infiltration in tumorswith an anti-CD8 IHC reagent (c) evaluating PD-L1 staining in differentcell types %, compartments or strength of staining (d) impact ofperitumoral vs intratumoral staining of PD-L1 or CD8 (e) impact ofamplification of PD-L1 staining (f) impact of macrodissection of tumorprior to qPCR or immunochip assessment (g) impact of tissue sample ageand fixation on PD-L1 status assessment and correlation with benefit (h)value of on-treatment tumor biopsy for assessing clinical benefit ortoxicity using the above described tumor characterization methods (i)value of FDG PET imaging and CT contrast enhancement for assessingon-treatment benefit or for patient selection (j) value of tumormutational/oncogene status (e.g., KRAS, bRAF, PI3K pathway mutationstatus, Met status, Her2neu status, PTEN status) in predicting benefitfor the above treatment (k) CTC number and PD-L1 characterization (1)circulating cell type, subset and number (m) circulating plasma/serumbiomarkers (n) ethnic differences (o) smoking status (p) FcgRIIIpolymorphism status (q) immune-related polymorphism status.

Study design. This study was a Phase I multicenter trial designed toevaluate the preliminary activity and safety of treatment withPD-L1/PD-1 pathway inhibition using an anti-PD-L1 antibody (MPDL3280A)in solid and liquid tumors. Over 250 patients were enrolled across morethan 17 multinational sites. Treatment with MPDL3280A was continueduntil progression of disease, unacceptable toxicity depending onclinical status of the patient (i.e., patients with evidence of diseaseprogression were allowed to continue on study treatment if theymaintained their ECOG PS and there was potential for clinical benefit asassessed by the investigator. An interim analysis of data from thisstudy was performed at multiple times after initiation of the study,including on Jan. 10, 2013, for patients enrolled on study, includingpatients that were enrolled prior to Jul. 1, 2012 (n=122). This datasuggests that patients whose tumors expressed lower levels of PD-L1 didderive minimal benefit from PD-L1/PD-1 pathway inhibition but thatpatients that had higher levels of PD-L1 in their tumor, particularly asmeasured on tumor immune infiltrating cells, derived the majority ofbenefit, as measured by durable responses, on study.

During the study, data on tumor measurement and survival status werecollected for evaluation of PFS, overall survival (OS) and overallresponse rate (ORR) and other measures as noted above. CT scans wereobtained at baseline and approximately every 6 weeks. Imaging in somepatients included FDG-PET imaging. Blood biomarkers were assessed atbaseline and on study for blood based and cell subset based biomarkers.Correlating these and other tumor biomarkers with clinical outcomes willassist in identifying predictive biomarkers, e.g., markers incirculation that may reflect drug activity or response to therapy. Bloodfor serum and plasma was drawn from consenting patients at pre-specifiedtimes and evaluated for levels of these exploratory markers.

Example 3 Scoring by IHC of Samples from Individuals Treated withAnti-PD-L1 Antibody Shows Correlation Between PD-L1 Expression withResponse to Treatment

As illustrated in FIG. 3A, tumor samples were analyzed for PD-L1expression from Phase I patients treated with the anti-PD-L1 antibodyMPDL3280A. The data set includes patients enrolled prior to Jul. 1,2012. Staining for PD-L1 status in tumor samples was performed using theIHC protocol described above.

The preliminary results show that there is a correlation between PD-L1expression in tumor infiltrating cells (IC) and the patients' clinicalresponse to anti-PD-L1 treatment. In particular, patients that displayedeither a partial response (PR) or complete response (CR) to anti-PD-L1treatment correlated with staining of PD-L1 expressing tumorinfiltrating cells within the tumor sample area, as detected by IHC. Thetumor sample area encompasses the malignant cells as well astumor-associated stroma, including areas of immune infiltratesimmediately adjacent to and contiguous with the main tumor mass. Incontrast, tumors of patients that displayed no clinical response toanti-PD-L1 treatment (e.g., exhibiting progressive disease (PD))exhibited lower PD-L1 expression in tumor infiltrating immune cellswithin the tumor sample area. p<0.0001.

A correlation between the patients' clinical response to anti-PD-L1treatment and the staining of PD-L1 expressing tumor infiltrating immunecells (IC) within total immune cells was also observed. As shown in FIG.3B, patients that exhibited responsiveness to treatment with anti-PD-L1treatment correlated with staining of PD-L1 expressing tumorinfiltrating cells within the total immune infiltrates within a tumorsample. The total number of immune infiltrates within a tumor sample wasdetermined by H&E staining. Patients displayed either a partial response(PR) or complete response (CR) to anti-PD-L1 treatment correlated withstaining of PD-L1 expressing tumor infiltrating cells within totalimmune infiltrates. In contrast, tumors of patients that displayed noclinical response to anti-PD-L1 treatment (e.g., exhibiting progressivedisease (PD)) exhibited lower PD-L1 expression in tumor infiltratingimmune cells within the tumor sample area. p<0.0005.

The preliminary data suggests that PD-L1 tumor status may be apredictive marker to identify patients who are more likely to respond tocancer therapy which involves inhibition of the PD-L1/PD-1 pathway usingan anti-PD-L1 antibody treatment. The initial clinical benefit observedthus far includes PR and/or CR, but continued monitoring may reflectadditional benefits including durability of response, evaluation of PFS,overall survival (OS) and overall response rate (ORR). This preliminarydata provides support that PD-L1 expression in tumor samples, includingexpression on tumor infiltrating immune cells (IC), may predictresponsiveness of a patient to cancer therapy which involves inhibitionof the PD-L1/PD-1 pathway using an anti-PD-L1 antibody treatment. Thedata further supports that PD-L1 tumor status may determine likelihoodthat a patient will exhibit benefit from treatment with an anti-PD-L1antibody.

Example 4 Scoring by qPCR of Samples from Individuals Treated withAnti-PD-L1 Antibody Shows Correlation Between PD-L1 Expression withResponse to Treatment

To evaluate whether PD-L1 gene expression status correlated with patientresponse to anti-PD-L1 treatment, the gene expression level of PD-L1 intumor samples was determined by qPCR. Tissue from Phase 1 patients weremacro-dissected to enrich for tumor content. RNA was isolated from theFFPE sections and PD-L1 gene expression was measured using PCR-basedmethodology (Fluidigm). PD-L1 expression was normalized to house-keepinggene (GusB).

FFPE RNA isolation

H&E sides from FFPE tumor specimens were verified by a pathologist fortissue diagnostic and tumor content assessment. If overall tumor contentwas less than 70-75%, RNA was isolated from macro-dissected tissue toenrich for tumor content.

FFPE tissue section was deparaffinized using Envirene reagent (HardyDiagnostics, Santa Maria, Calif., USA) before tissue lysate wasprepared. RNA isolation was performed using the LC Pertuzumab FFPET RNAkit (Roche Diagnostic part #06474 969 001). RNA concentration and260/280 ratio was determined by NanoDrop® ND-2000/8000 UV-VisSpectrophotometer. For each sample, 2 Ong-200 ng RNA (2 μL in volume)was used for Gene expression analysis using the BioMark Real-Time PCRPlatform (Immune Fluidigm panel). 110 ng-115 ng RNA was used for PDL1qPCR assay.

PD-L1 qPCR assay

PD-L1 qPCR was performed using PDL1 mRNA qRT-PCR assay developed byRoche Molecular Science (RMS). PDL1 and reference genes (GusB orTMEM55B) mRNA was reverse-transcribed, amplified and detected usingreaction mix and Oligo Mix provided by RMS and according to themanufacturer instructions. The thermal cycling conditions were asfollows: 1 cycle of 50° C. for 5 min, 1 cycle of 95° C. for 1 min, 1cycle of 61° C. for 30 min, then 2 cycles of 95° C. for 15 sec and 61°C. for 30 sec, then 53 cycles of 92° C. for 15 sec and 61° C. for 30sec, followed by 1 cycle of 40° C. for 30 sec and 25° C. for 10 sec. Thereaction was performed in Cobas z480 Analyzer (Roche). PD-L1 expressionlevels were determined using the delta Ct (dCt) method as follows:Ct(PD-L1)-Ct(Reference Gene). The data set includes patients withsamples available before Nov. 1, 2012.

As illustrated in FIG. 4, the preliminary results show that there is acorrelation between elevated PD-L1 gene expression in tumor samples andthe patients' clinical response to anti-PD-L1 treatment. Patients thatdisplayed either a partial response (PR) or complete response (CR) toanti-PD-L1 treatment correlated with PD-L1 gene expression within thetumor sample. In contrast, tumors of patients that displayed no clinicalresponse to anti-PD-L1 treatment (e.g., displaying progressive disease(PD)) exhibited lower PD-L1 gene expression within the tumor sample.p=0.0037.

This preliminary data suggests that PD-L1 tumor gene expression statusmay be a useful biomarker to predict responsiveness of a patient tocancer therapy which involves inhibition of the PD-L1/PD-1 pathway usingan anti-PD-L1 antibody. The PD-L1 tumor gene expression profile may bederived from the tumor cells, tumor infiltrating cells or a combinationof both.

Example 5 Scoring by qPCR of Samples from Individuals Treated withAnti-PD-L1 Antibody Shows Correlation Between PD-1 Expression withResponse to Treatment

In addition to the correlation observed between PD-L1 gene expression intumor samples and the patient clinical response, PD-1 gene expressionstatus also shown to correlate with clinical response. As shown in FIG.5, a correlation between PD-1 gene expression in tumor samples and thepatients' clinical response to anti-PD-L1 treatment was observed.Patients that displayed a partial response (PR) to anti-PD-L1 treatmentcorrelated with PD-1 gene expression within the tumor sample. Incontrast, there was less correlation of PD-1 gene expression status withpatients that displayed no clinical response to anti-PD-L1 treatment(e.g., PD). p=0.0206. The data set includes patients with samplesavailable before Nov. 1, 2012.

This preliminary data suggests that PD-1 tumor status may be anotherpredictive marker to identify patients who are more likely to respond tocancer therapy which involves inhibition of the PD-L1/PD-1 pathway usingan anti-PD-L1 antibody treatment. PD-1 gene expression in tumor samples,including expression in tumor infiltrating immune cells (IC), tumorcells or a combination of the two, may predict responsiveness of apatient to cancer therapy which involves inhibition of the PD-L1/PD-1pathway using an anti-PD-L1 antibody treatment.

This preliminary data suggests that PD-1 tumor status may be anotherpredictive marker to identify patients who are more likely to respond tocancer therapy which involves inhibition of the PD-L1/PD-1 pathway usingan anti-PD-L1 antibody treatment. PD-1 gene expression in tumor samples,including expression in tumor infiltrating immune cells (IC), tumorcells or a combination of the two, may predict responsiveness of apatient to cancer therapy which involves inhibition of the PD-L1/PD-1pathway using an anti-PD-L1 antibody treatment.

Example 6 Tumor Immune Gene Signature of Samples from IndividualsTreated with Anti-PD-L1 Antibody Shows Correlation with Response toTreatment

To determine whether a correlation exists between certain immune genesignatures and a patients' responsive to treatment with anti-PD-L1antibody, the following protocol was performed.

Fluidigm Gene Expression Analysis

Gene expression analysis was performed using the BioMark Real-Time PCRPlatform (Immune Fluidigm). 2 μl of total RNA was reverse-transcribed tocDNA and pre-amplified in a single reaction using SuperscriptIII/Platinum Taq and 2× reaction mix (Invitrogen). 96 Taqmanprimer/probe sets were included in the pre-amplification reaction at afinal dilution of 0.2× Taqman assay concentration (Applied Biosystems).The thermal cycling conditions were as follows: 1 cycle of 50° C. for 15min, 1 cycle of 70° C. for 2 min, then 18 cycles of 95° C. for 15 secand 60° C. for 4 min.

Pre-amplified cDNA was diluted 1.94-fold and then amplified using TaqmanUniversal PCR MasterMix (Applied Biosystems) on the BioMark BMK-M-96.96platform (Fluidigm) according to the manufacturer's instructions. Allsamples were assayed in triplicate. All Taqman assays in the expressionpanel were FAM-MGB and ordered through Life Technologies eithermade-to-order or custom-designed, including five reference genes, GusB,SDHA, SP2, TMEM55B and VPS-33B. A median of the Ct values for thereference genes was calculated for each sample, and expression levelswere determined using the delta Ct (dCt) method as follows: Ct(TargetGene)-Median Ct(Reference Genes). Alternatively, whenever indicated, theexpression levels were determined after normalizing Ct values of eachtarget gene to the median Ct value of all genes.

As illustrated in FIG. 6, a correlation exists between certain immunegene signatures and the response of patients to treatment withanti-PD-L1 antibody. The results show that the expression of certainimmune genes was correlated with patient response to treatment withanti-PD-L1 antibody. For example, the T cell activation immune genes,including IFN-g, CD8A, EOMES, Granzyme A and CXCL9, were found tocorrelate with patient partial response to treatment with anti-PD-L1.The data set includes patients with samples available before Nov. 1,2012.

This preliminary data suggests that additional predictive biomarkershave been identified which may help to identify patients who are morelikely to respond to cancer therapy which involves inhibition of thePD-L1/PD-1 pathway using an anti-PD-L1 antibody treatment. The immunegene signature includes, but is not limited to, IFN-g, CD8A, EOMES,Granzyme A and CXCL9, and is associated with immune cell activation.

Example 7 Correlation of PD-L1 and PD-L2 Expression with Response toAnti-PD-L1 Antibody Treatment

Clinical activity, safety and biomarkers of patients with locallyadvanced or metastatic tumors treated with a PD-L1 axis bindingantagonist, such as an anti-PD-L1 antibody.

PD-L1 and PD-L2 have been reported to regulate Th1 and Th2 immuneresponses. Tumor-expressed PD-L1, when bound to PD-1 or B7.1 onactivated T cells, can mediate cancer immune evasion Inhibiting thebinding of PD-L1 to its receptors represents an attractive strategy torestore tumor-specific T-cell immunity. However, PD-L2 expressed in thetumor microenvironment may also bind PD-1-expressing T cells, dampeningtheir function. MPDL3280A (anti-PD-L1 antibody), a human monoclonalantibody containing an engineered Fc-domain designed to promote aTh1-driven response to optimize efficacy and safety, is described herealong with Phase I results.

Materials and Methods: A study was conducted with MPDL3280A administeredIV q3w in patients with locally advanced or metastatic solid tumors,including 3+3 dose-escalation and expansion cohorts. ORR was assessed byRECIST v1.1 and includes u/cCR and u/cPR. PD-L1 was measured by IHC (posvs. neg), and PD-L2 was measured by qPCR (high vs low) in archival tumorspecimens.

Results: As of Feb. 1, 2013, 171 patients were evaluable for safety.Administered doses include ≤1 (n=9), 3 (n=3), 10 (n=35), 15 (n=57) and20 mg/kg (n=67). Patients in the dose-escalation cohorts did notexperience dose limiting toxicities (DLTs). No maximum tolerated dose(MTD) was identified. Patients had received MPDL3280A for a medianduration of 147 days (range 1-450). 41% of patients reported G3/4 AEs,regardless of attribution. No acute pneumonitis was observed. 122patients enrolled prior to Jul. 1, 2012 were evaluable for efficacy.RECIST responses were observed in multiple tumor types including NSCLC(9/37), RCC (5/39), melanoma (9/35), CRC (1/4) and gastric cancer (1/1).An ORR of 21% (25/122) was observed in non-selected solid tumors with aduration of response range of 1+ to 253+ days. Other patients haddelayed responses after apparent radiographic progression (not includedin the ORR). The 24-week PFS was 42%. 94 patients had tumors evaluablefor PD-L1 status, and 81 patients had tumors evaluable for PD-L2. MedianPD-L2 expression was ≈2× higher in PD-L1-positive tumors versusPD-L1-negative tumors. The ORR was 39% (13/33) for patients withPD-L1-positive tumors versus 13% (8/61) for patients with PD-L1-negativetumors. Patients with PD-L2 High tumors showed an ORR of 27% (11/41),versus 13% (5/40) for patients with PD-L2 Low tumors.

MPDL3280A was well tolerated, with no pneumonitis-related deaths.Durable responses were observed in a variety of tumors. PD-L1 and PD-L2tumor status appears to correlate with responses to MPDL3280A. Thispreliminary data provides additional support that PD-L1 as well as PD-L2expression in tumor samples, including expression on tumor cells, tumorinfiltrating immune cells (IC), and/or within the tumor microenvironmentsuch as stromal cell and any combinations thereof, may predictresponsiveness of a patient to cancer therapy which involves inhibitionof the PD-L1/PD-1 pathway. The data further supports that PD-L1 andPD-L2 tumor status may determine likelihood that a patient will exhibitbenefit from treatment with a PD-L1 axis binding antagonist such as ananti-PD-L1 antibody.

Example 8 Anti-PD-L1 Antibody Treatment Leads to Increased T-CellActivation in PD-L1+ Patients Responding to Treatment

The value of on-treatment tumor biopsy for assessing clinical benefit topatients responding to anti-PD-L1 antibody and the identification ofpharmacodynamic (PD) biomarkers associated with treatment effectivenesswas evaluated.

As illustrated in FIG. 7, serial pre-/on-treatment tumor biopsies frompatients treated with anti-PD-L1 antibody from the ongoing Phase I studywere assessed. Paired baseline (which includes either pre-treatment orarchival tumor tissue) and on-treatment tumor biopsies from patientstreated with anti-PD-L1 antibody (n=26) suffering from variousindications including melanoma, RCC, NSCLC, H&N, CRC, gastric, andbreast cancer, were analyzed for CD8+ T cell infiltration using ananti-CD8 IHC reagent as well as pharmacodynamic biomarkers via geneexpression analysis.

As illustrated in FIG. 8(a), an increase in CD8+ T cell infiltration wasassociated with an increase in PD-L1 expression in tumor samples frompatients responding to treatment with anti-PD-L1 antibody. Underbaseline conditions, T-cells and PD-L1+ tumor cells may co-localize andfocal PD-L1 expression may represent an interface between cancer cellsand immune cells (anti-tumor T-cell attack may be controlled by tumor orimmune cell PD-L1 expression). At week 4 post Cycle 1 Day 1 (C1D1)treatment with anti-PD-L1 antibody, an increase in PD-L1 expressionwithin the tumor sample was detected along with dense lymphocyticinfiltration, in particular CD8+ T cell infiltration. This increase inCD8+ T cells may lead to T-cell mediated killing of tumor cells which inturn may lead to T-cell proliferation and activation. Such activatedT-cells may release IFN-g and may also induce PD-L1 expression inneighboring tumor cells and/or immune cells.

As illustrated in FIG. 8(b), a number of T-cell activation markers werefound to be increased in patients responding to anti-PD-L1 antibodytreatment. The gene expression levels of T cell activation markers,including Granzyme A, Perforin, IFN-g, TNFa and CD8, were found to beincreased following treatment with anti-PD-L1 antibody in patientsresponding to treatment with anti-PD-L1 antibody compared to baselinelevels pre-treatment.

This data suggests that an increase in CD8+ T cell infiltrationcorrelated with an increase in PDL-1 expression in tumor samples frompatients responding to anti-PD-L1 antibody treatment. Furthermore, theexpression of a number of T cell activation markers, including but notlimited to, Granzyme A, Perforin, IFN-g, TNFa and CD8, were found to beincreased in tumor samples from patients responding to anti-PD-L1antibody treatment. These markers may be useful pharmacodynamicbiomarkers to assess clinical benefit and efficacy of therapy thatinvolves inhibition of the PD-L1/PD-1 pathway which includes using ananti-PD-L1 antibody.

Example 9 Adaptive Increase in PD-L1 Expression is Prominent in PatientsResponding to Treatment

In addition to the increase in CD8+ T cell infiltration and expressionof T cell activation markers in tumor samples from patients respondingto anti-PD-L1 antibody treatment, an increase in tumor PD-L1 expressionwas also observed in patients responding to anti-PD-L1 antibodytreatment.

As illustrated in FIG. 9, a summary of responses to anti-PD-L1 antibodyin paired tumor biopsies is presented. In all instances (4/4 patients;100%) where there was >30% reduction in the sum of the longest diameterof the target lesions (SLD) in patients responding to anti-PD-L1antibody treatment, there was also an increase in the tumor PD-L1expression as measured by PD-L1 IHC. Even with a 0-30% reduction in SLDin patients responding to anti-PD-L1 antibody treatment, 33% of thepatients ( 2/6 patients) displayed an increase in the tumor PD-L1expression following treatment.

In contrast, in patients that did not respond to anti-PD-L1 antibodytreatment and that displayed a 0-20% increase in SLD, only 1/10 patientsdisplayed an increase in tumor PD-L1 expression. Furthermore, forpatients that displayed >20% increase in SLD, none ( 0/4 patients)displayed any measurable increase in tumor PD-L1 expression.

This preliminary data suggests that PD-L1 expression in tumors mayincrease in patients responding to treatment with anti-PD-L1 antibodyand that such an increase may be an adaptive increase that may serve aspharmacodynamic biomarkers, an indicator of local tumor infiltratingleukocytes (TILs) attacking the tumor and also as a marker to assessclinical benefit and efficacy of therapy that involves inhibition of thePD-L1/PD-1 pathway which includes using an anti-PD-L1 antibody.

Example 10 Anti-PD-L1 Antibody Treatment Leads to Increased Frequency ofActivated T-Cells in Blood

The identification of pharmacodynamic (PD) biomarkers of anti-PD-L1antibody treatment in the blood was also evaluated.

Flow Cytometry (FACS) Analysis:

Whole blood was collected in sodium heparin (NaHep) blood collectiontubes. Blood was mixed by slowly inverting the collection tube. Thecells were stained with the appropriate antibody combinations andincubated at room temperature for 30 minutes in the dark. Afterincubation, FACSLyse was added to all tubes. The tubes were vortexed andincubated at room temperature in the dark for 10 minutes. The cells werewashed with PBS with 1% BSA. After washing, FACSPerm2 was added to alltubes and incubated at room temperature in the dark for 10 minutes.After incubation, the cells were washed with PBS with 1% BSA andincubated with antibody, if applicable. After the incubation, cells werewashed with PBS with 1% BSA and resuspended in 1% Paraformaldehyde. Thetubes were stored at 2-8° C. until they were acquired on the FACSCantoIIflow cytometer.

As illustrated in FIG. 10(a), proliferating T-cells in blood, identifiedas being CD8+/Ki67+, increase during the course of anti-PD-L1 antibodytreatment with a ˜2-fold increase at C2D1 (Cycle 2 Day 1) compared toC1D1 (Cycle 1 Day 1). Furthermore, as illustrated in FIG. 10(b),proliferating T-cells that are also activated in blood, identified asbeing CD8+/HLA-DR+/Ki67+, increase during the course of anti-PD-L1treatment and are more frequent at C2D1 (˜2-fold increase).

This preliminary data suggests that activated T-cell proliferation inblood may increase during the course of anti-PD-L1 antibody treatmentand may serve as a pharmacodynamic biomarker of therapy that involvesinhibition of the PD-L1/PD-1 pathway which includes using an anti-PD-L1antibody.

Example 11 A Decrease in IL-6 Expression in Plasma May be Associatedwith Patients Responding to Treatment

The identification of pharmacodynamic (PD) biomarkers of anti-PD-L1antibody treatment in the plasma was also evaluated.

Plasma Analysis

Blood was collected into Sodium Heparin collection tubes. Tube was mixedthoroughly by slowly inverting the collection tube. Subsequently,collection tubes were centrifuged in a refrigerated centrifuge at aminimum of 1500-2000× g for 15 minutes. Plasma was transferred topolypropylene cryovials and kept frozen until analysis. Plasma wasanalyzed for IL-6 and other cytokines using modified ELISA according tomanufacturer recommendations.

As illustrated in FIG. 11, a decrease in IL-6 levels in the plasma wasassociated with patients responding to the anti-PD-L1 antibodytreatment. Specifically, patients that exhibited beneficial PR/CRresponses (partial response/complete response) over the course oftreatment also exhibited a measurable decrease in the IL-6 levels.

In contrast, patients that did not benefit from treatment withanti-PD-L1 antibody was associated with an increase in IL-6 levels inthe plasma over the course of treatment. As illustrated in FIG. 11,patients that exhibited PD responses (progressive disease) over thecourse of treatment exhibited a measurable increase in the IL-6 levels.

This preliminary data suggests that IL-6 levels in plasma may serve as apharmacodynamic biomarker to assess clinical benefit and efficacy oftherapy that involves inhibition of the PD-L1/PD-1 pathway whichincludes using an anti-PD-L1 antibody.

Example 12 Tumor Immune Gene Expression in Samples from IndividualsTreated with Anti-PD-L1 Antibody Shows Correlation with Response toTreatment

To further evaluate additional immune gene signatures and a patients'responsiveness to treatment with protocol, gene expression analysis wasperformed as previously described in Example 6 using Fluidigm geneexpression analysis.

As illustrated in FIG. 12, a correlation exists between a number ofadditional immune related genes and the response of patients totreatment with anti-PD-L1 antibody. Specifically, the gene expressionlevels of CTLA4 and CD45RO were observed to be higher in patients thateither displayed partial response (PR) or complete response (CR)following treatment with anti-PD-L1 antibody, as compared to patientswith progressive disease (PD). FIG. 12 also illustrates that the geneexpression levels of CX3CL1 (a chemokine), LGLS9 (Galectin-9), MIC-A andMIC-B were observed to be lower in patients responding to treatment withanti-PD-L1 antibody (PR/CR), as compared to patients with PD. HK. Thisdata represents pooled gene expression levels from samples collectedfrom patients suffering from the following cancer indications: melanoma,RCC, NSCLC, CRC, gastric cancer, bladder cancer, ovarian cancer, breastcancer, head & neck cancer, pancreatic cancer, sarcoma, esophagealcancer, SCLC, multiple myeloma, NHL, and endometrial cancer.

Interestingly, certain immune related genes display differentcorrelation patterns with the patients' response to treatment withanti-PD-L1 antibody depending on the disease indication. As illustratedin FIG. 13, the gene expression level of IDO1 (Indoleamine-pyrrole2,3-dioxygenase) was higher in melanoma patients that either displayedpartial response (PR) or complete response (CR) following treatment withanti-PD-L1 antibody, as compared to patients with progressive disease(PD). However, in NSCLC patients, the gene expression level of IDO1 waslower in patients that either displayed PR or CR following treatmentwith anti-PD-L1 antibody, as compared to patients with PD. Thus, it ispossible that these biomarkers may show differing correlation profilesdepending on the disease indication.

These results suggest that additional predictive biomarkers have beenidentified which may help to identify patients who are more likely torespond to cancer therapy which involves inhibition of the PD-L1/PD-1pathway, such as using an anti-PD-L1 antibody.

Example 13 PD-L1 Expression on Circulating T Cells in Blood Correlateswith Response to Treatment with Anti-PD-L1 Antibody

To evaluate whether PD-L1 expression on circulating T cells correlatedwith patient response to treatment with anti-PD-L1 antibody, bloodsamples were collected within 60 days prior to treatment and FACsanalysis was performed to determine the level of PD-L1 expression on Tcells in the sample.

Briefly, blood samples from pre-treatment patients were collected intubes containing anti-coagulant (e.g. sodium heparin, EDTA, or citrate).The collected blood was mixed in the collection tubes thoroughly byslowly inverting the collection tube at least 3 times. Approximately 100μL of an anticoagulated whole blood was pipetted into appropriatelylabeled test tubes. The blood was stained with the following primaryantibodies and incubated at room temperature for 30 minutes in the dark:anti-CD3 antibody, anti-CD8 antibody and anti-PD-L1 antibody. Followingprimary antibody staining, the red blood cells were then lysed using forexample ammonium chloride lysing solution, and then cells were washedwith 2 mL PBS with 1% BSA. The blood cells were then stained withsecondary antibody or an appropriate amount of streptavidin-(dye) (ifbiotinylated primary antibody were used) for 20 minutes in the dark atroom temperature. Cells were then washed again with PBS containing 1%BSA, resuspended in 1% paraformaldehyde and stored at 2-8° C. until theywere acquired on the flow cytometer.

As shown in FIG. 14, there is a correlation between elevated PD-L1expression on circulating T cells (CD3+/CD8+) and the patients' clinicalresponse to anti-PD-L1 treatment. Patients that displayed wither apartial response (PR) or complete response (CR) following anti-PD-L1treatment correlated with elevated levels of PD-L1 expression on theircirculating T cells. In contrast, patients that displayed no clinicalresponse to anti-PD-L1 treatment (e.g., having progressive disease (PD))exhibited lower PD-L1 expression on their circulating T cells.

These results suggest that PD-L1 expression on circulating T cells maybe a valuable and useful biomarker for predicting responsiveness of apatient to cancer therapy which involves inhibition of the PD-L1/PD-1pathway using, for example, an anti-PD-L1 antibody.

Example 14 A Phase 1a Study of Individuals Treated with Anti-PD-L1Antibody and the Correlation with Response to Treatment in DiagnosticSelected Individuals

Study PCD4989g is an ongoing Phase Ia trial in patients with advancedsolid tumors and hematologic malignancies to evaluate the safety andtolerability of an anti-PD-L1 antibody (MPDL3280A) administered byintravenous infusion every 3 weeks. The study contains a large cohort ofNSCLC patients (n=79, including 53 with a minimum of 6 months offollow-up).

These preliminary results from Study PCD4989g suggest that PD-L1expression in tumor-infiltrating immune cells is associated withresponse to MPDL3280A. PD-L1 positivity in NSCLC is defined asdiscernible PD-L1 staining of any intensity in tumor-infiltrating immunecells covering 5% of tumor area occupied by tumor cells, associatedintratumoral, and contiguous peri-tumoral desmoplastic stroma. Theproposed criteria for PD-L1 diagnostic assessment in NSCLC is providedbelow:

IHC PD-L1 Diagnostic Assessment Scores Absence of any discernible PD-L1staining IHC 0 OR Presence of discernible PD-L1 staining of anyintensity in tumor-infiltrating immune cells covering <1% of tumor areaoccupied by tumor cells, associated intratumoral, and contiguousperi-tumoral desmoplastic stroma Presence of discernible PD-L1 stainingof any intensity in IHC 1 tumor-infiltrating immune cells coveringbetween ≥1% to <5% of tumor area occupied by tumor cells, associatedintratumoral, and contiguous peri-tumoral desmoplastic stroma Presenceof discernible PD-L1 staining of any intensity in tumor IHC 2infiltrating immune cells covering between ≥5% to <10% of tumor areaoccupied by tumor cells, associated intratumoral, and contiguousperi-tumoral desmoplastic stroma Presence of discernible PD-L1 stainingof any intensity in tumor IHC 3 infiltrating immune cells covering ≥10%of tumor area occupied by tumor cells, associated intratumoral, andcontiguous peri- tumoral desmoplastic stroma

As of the data cutoff of 30 Apr. 2013, there were 53 patients withlocally advanced or metastatic NSCLC dosed prior to 1 Oct. 2012 with aminimum of 6 months of follow-up. The median age of this group was 62years (range, 24-84 years), and the group represented a heavilypre-treated patient population: 84.9% had ≥2 prior systemic therapiesand 52.8% had ≥4 prior systemic therapies. Dramatic responses have beenobserved in NSCLC, including in patients who failed multiple systemictherapies and/or who had been symptomatic prior to starting treatment.The median time to response is 11.7 weeks, with approximately 90% ofresponses observed by 24 weeks (6 months). The objective response rate(ORR) in all NSCLC patients with a minimum of 6 months of follow-up is22.6% (95% CI: 12.3%-35.1%).

PD-L1 positivity of tumor-infiltrating immune cells appeared to predicta higher response in NSCLC patients treated with MPDL3280A. NSCLCpatients with ≥5% PD-L1-positive tumor-infiltrating immune cells (IHC2/3) had an ORR of 46.2% (95% CI: 22.4%-74.0%) compared with the 18.2%(95% CI: 8.2%-33.8%) in patients with diagnostic profiles of IHC 0/1.When a higher diagnostic threshold of ≥10% PD-L1-positivetumor-infiltrating immune cells (IHC 3) was used, PD-L1-positivepatients had an ORR of 83.3% (95% CI: 40.2%-99.1%) compared with the17.5% (95% CI: 7.8%-31.5%) in patients with diagnostic profiles of IHC0/1. Preliminary experience shows that the diagnostic cutoff of IHC 2/3is associated with significant clinical benefit for NSCLC patientstreated with MPDL3280A. Patients who responded appeared to havedeveloped durable anti-tumor immunity, with all NSCLC responsescontinuing with 170 to 534 days on study at the time of data cutoff.

Example 15 Tumor Immune Gene Signature of Samples from IndividualsTreated with Anti-PD-L1 Antibody Shows Correlation with Response toTreatment

Immunologic pharmacodynamics effects were evaluated in tumors and bloodsfrom patients treated with MPDL3280A. On treatment, responding tumorsshowed increase in expression of tumor cell and tumor infiltratingimmune cell PD-L1 expression, infiltration of CD8+ T-cells and aTh1-dominant immune infiltrate, providing evidence for adaptive PD-L1up-regulation. Non-responders showed minimal tumor CD8+ T-cellinfiltration and an absence of T-cell activation (measured by Granzymes,Perforin and EOMES expression).

As illustrated in FIG. 15, anti-tumor response to MPDL3280A wasassociated with markers related to T-cell biology. Specifically, highergene expression of cytotoxic Th1 cells, IFN-g and T-cell traffickingmarkers were detected in tumor tissue at baseline and this wasassociated with MPDL3280A activity. For example, the T cell activationimmune genes, including IFN-g, CD8A, Granzyme B and CXCL9, were found tocorrelate with patient partial response/complete response to treatmentwith MPDL3280A. The data set includes patients with samples available asof Jun. 1, 2013.

As illustrated in FIG. 16, MPDL3280A leads to increased T cellactivation in a patient with melanoma responding to treatment.Specifically, a number of T-cell activation markers were found to beincreased in patients responding MPDL3280A including Granzyme A,Granzyme B, Perforin, EOMES, IFN-g, TNF, CXCL9, CXCL10, CD8A and ICOS.

In contrast, in a patient with melanoma not responding to MPDL3280Aexhibited low frequency of intratumoral T cells and lacks T cellactivation, as illustrated in FIG. 17.

Circulating biomarkers for their association with clinical outcomes wasalso evaluated. The frequency of CD8+HLA-DR+Ki67+ T-cells in the bloodincreased shortly following the first dose of MPDL3280A and returned tobaseline levels by the end of cycle 2 when assessed in all patients,representing a transient pharmacodynamic measurement of PD-L1inhibition. As illustrated in FIG. 18, MPDL3280A leads to transientincrease in the frequency of activated T cells in blood and suggeststhat CD8+HLA-DR+Ki67+ T-cells may be a potential pharmacodynamicsbiomarker of MPDL3280A treatment.

Significant fluctuations in CD4+/ICOS+ T cells were observed, withdelayed increases in this T cell population correlating with responseand decreases with disease progression (occurring after cycle 3), asillustrated in FIG. 19. The increase in CD4+/ICOS+ T cells might reflectthe ancillary activation of T helper cell responses in patients whomount strong CD8+ anti-tumor T cell responses following treatment withto MPDL3280A.

Furthermore, an adaptive increase in PD-L1 expression was prominent inpatients responding to MPDL3280A. As illustrated in FIG. 20, a summaryof responses to MPDL3280A in paired tumor biopsies is presented. Inpatients responding to MPDL3280A, there was an increase in both thetumor cell PD-L1 expression as well as an increase in the tumorinfiltrating immune cell PDL-1 expression, as measured by a PD-L1 IHCassay.

Example 16 CTLA4 and Fractalkine Expression Correlation with Response orProgression Following Anti-PD-L1 Antibody Treatment

Across multiple cancer types, pre-treatment tumors exhibiting thepresence of Th1-related gene expression, CTLA4, and the absence offractalkine/CX3CL1, were associated with activity. Specifically, theexpression of CTLA4 strongly correlated with response to MPDL3280A.while the expression of fractalkine/CX3CL1 in pre-treatment tumorsstrongly correlated with progression to MPDL3280A, as illustrated inFIG. 21. The role of CTLA4 is well established as a factor expressed byT cells that can lead to inhibiting further T cell activation. Thecorrelation of higher pre-treatment CTLA4 expression in patients thatresponded to MPDL3280A across the different tumor types suggests thatCTLA4 serves as an important feedback mechanism in the anti-cancerimmune response, and represents a marker of active T cell immunity andinflammation. In the periphery, however, the functional role of CTLA4 asa negative regulator appears less important than that of PD-L1.

The correlation of higher pre-treatment fractalkine (CX3CL1) expressionin patients that experienced progression of disease to MPDL3280A wasalso unexpected, since this chemokine is generally associated withdriving T cell infiltration. However, in its uncleaved form, fractalkineinduces lymphocyte adhesion to endothelial cells and therefore mayactually restrict T cell entry into the tumor bed. The association offractalkine expression in tumors and progressive disease for patientstreated with MPDL3280A suggests that fractalkine expression could alsorepresent a feedback mechanism for tumors lacking an active immuneresponse or represent an active tumor immune response suppressivefactor.

These results suggest that CTLA4 and fractalkine may be valuablepredictive biomarkers to help to identify patients who are more likelyto respond to cancer therapy which involves inhibition of the PD-L1/PD-1pathway, such as using an anti-PD-L1 antibody.

Example 17 Tumor Infiltrating Lymphocyte Signatures Across Six CancerTypes and their Association with Disease Prognostic Factors

To further evaluate and understand the complexity of factors that maymodulate or inhibit anti-tumor immunity and thus contribute to responseor resistance to immune modulatory therapy, a number of highly sensitiveimmune gene expression assays (iCHIP) using the Fluidigm Biomarkplatform were used to interrogate the quality of the immune responseacross six cancer indications including CRC (n=48), BC (n=126), NSCLC(n=51), Melanoma (n=35), RCC (n=48), and bladder cancer (n=42). TheiCHIP platform consists of 96 genes that represent signatures associatedwith IFNg pathway, cytotoxic T-cells, Th2 cells, T-effector cells,T-effector cells, T-regulatory cells, Th17 cells, myeloid cells,dendritic cells, NK cells, B-cells and immune checkpoint markers.

RNA was extracted from formalin-fixed paraffin embedded archival tissuesthat were derived from clinical collections or collected in the ongoingPhase I study of MPDL3280A (anti-PD-L1 antibody). Appropriate patientinformed consents were obtained from the institutional review boards forthe exploratory evaluation of biomarkers.

As shown in FIG. 22, the gene signatures associated with Teff(T-effector cells), Treg (T-regulatory cells), and Th17 is shown. Teffcells are defined by the gene cluster: CD8A, GZMB, IFNg, EOMES, GZMA,Perforin; Treg cells are defined by the gene cluster: FOXP3; and Th17cells are defined by the gene cluster: RORC, IL17F, IL17A.

Immune gene expression analysis showed a unique pattern ofimmunosuppressive and immunoresponsive factors and cell types acrossindications. While indications, including triple-negative breast cancer(TNBC), NSCLC and bladder cancer represent the highest prevalence ofIFN-g signatures, CRC and hormone receptor-positive breast cancerconstitute diseases with the lowest expression. In addition to a highIFN-g signature in TNBC, this subtype of breast cancer also consists ofa high Treg signature when compared to melanoma, which represents thehighest ratio of IFN-g:Treg gene expression. Th17 gene signatures aremost prevalent in CRC compared to all other indications. Association ofthese gene signatures with disease stage, outcomes (where available) andother disease specific known prognostic factors including molecularsubtypes and mutations in KRAS, BRAF, PIK3CA and EGFR is currentlyongoing.

In particular, in a cohort of RCC patients, a trend toward higher tumorgene expression of IL17F in patients who do not respond to anti-PD-L1treatment was observed as illustrated in FIG. 23, despite the tumor geneexpression of PD-L1 (CD274) being higher in responders to anti-PD-L1treatment.

Furthermore, tumor gene expression of IL-17F is higher in patients witha late response to anti-PD-L1 (respond after 6 months of therapy) acrossindications (melanoma, lung cancer, RCC), as illustrated in FIG. 24.

Thus, it is possible that certain biomarkers may show differingcorrelation profiles depending on the disease stage and timing oftherapy involving inhibition of the PD-L1/PD-1 pathway.

Example 18 Inhibition of PD-L1 by MPDL3280A Leads to Clinical Activityin Patient with Metastatic Urothelial Bladder Cancer (UBC)

Metastatic UBC is associated with a poor prognosis and limited treatmentoptions. PD-L1 expression is prevalent in this disease and may protectcancer cells from immune-mediated destruction by binding to itsreceptors PD-1 and B7.1.

In a Phase I study, UBC patients received MPDL3280A 15 mg/kg IV q3w forup to 1 year. Objective response rate (ORR; including unconfirmedresponses) was assessed by RECIST v1.1. In parallel, tumor andcirculating biomarkers were evaluated to study MPDL3280A immunecorrelates.

As of Sep. 19, 2013, 31 PD-L1+ UBC patients were treated with MPDL3280A.Patients were 84% male, had a median age of 66 y (42-86), 57% were ECOGPS 1 and 68% had visceral metastases. 71% received ≥2 prior therapies;97% received prior platinum-based chemotherapy. Patients had receivedMPDL3280A for a median duration of 43 d (1-153) as of the data cutoff.The G1-4 treatment-related AEs occurring in ≥2 patients were pyrexia,anemia, decreased appetite, fatigue and nausea. Related G3-4 AEsoccurred in 3.2% of patients. There were no immune-related AEs. 20patients were evaluable for efficacy at time of analysis with a medianfollow up of 2.8 m (1.4-5). The ORR was 50% (1 CR and 9 PRs) with amedian time to response of 43 d (39-82), corresponding to the firstradiographic assessment and including patients with CNS, lung and bonemetastases at baseline. All responders were still responding at the timeof clinical cutoff.

Associations have been observed between PD-L1 status on tumorinfiltrating immune cells and response to anti-PD-L1 treatment andfurther evaluations are ongoing to determine the association of PD-L1status on tumor cells and response to anti-PD-L1 treatment.

Treatment resulted in transient increases in circulating Ki-67+CD8+ Tcells, representing a potential pharmacodynamic (PD) biomarker ofactivity to therapy in patients with UBC with an inhibitor of thePD-1/PD-L1 pathway. As illustrated in FIG. 25, circulating Ki-67+CD8+ Tcells demonstrated a transient rise during treatment with MPDL3280A.

Treatment also resulted in transient increase in plasma proteins, suchas IL-18, which is upstream of IFN-g signaling, representing another PDbiomarkers of activity, as illustrated in FIG. 26. Furthermore, baselineplasma MCP-1 was lower in patients with partial response/completeresponse (PR/CR). Both IL-18 and MCP-1 were predominantly expressed inmonocytes, a component of the myeloid cells (see FIG. 26).

Gene expression data from pretreatment tumors showed that patients whoprogressed had a proportionally higher myeloid gene signature. Asillustrated in FIG. 27, patients that had progressive disease (PD)displayed elevated levels of IL-8, CCL2, and IL1B and these wereassociated with being present predominantly in myeloid type cells (e.g.,monocytes, dendritic cells).

MPDL3280A was well tolerated in this pretreated PD-L1+ UBC population.50% of patients treated responded to treatment. Responses were rapid andon-going. Biomarker analysis revealed PD markers, as well as markers ofpotential mechanisms of resistance to therapy.

Example 19 Elevated Levels of Soluble PD-L1 is Prominent in PatientsResponding to Treatment

Elevated baseline plasma levels of soluble PD-L1 was also observed inblood samples from patients responding to anti-PD-L1 antibody treatmentin the ongoing Phase 1 study.

Blood was collected into Sodium Heparin collection tubes. Tube was mixedthoroughly by slowly inverting the collection tube. Subsequently,collection tubes were centrifuged in a refrigerated centrifuge at aminimum of 1500-2000× g for 15 minutes. Plasma was transferred topolypropylene cryovials and kept frozen until analysis. Plasma wasanalyzed for IL-6 and other cytokines using modified ELISA according tomanufacturer recommendations.

As illustrated in FIG. 28, patients with RCC that responded toanti-PD-L1 antibody treatment with a >=30% reduction in the sum of thelongest diameter of the target lesions (SLD) was found to correlate witha higher level of soluble PD-L1 (sPDL1) in their plasma samples thanpatients that only displayed a >=20% reduction in the SLD.

This preliminary data suggests that soluble PD-L1 expression in theplasma may be a valuable and useful biomarker for predictingresponsiveness of a patient to cancer therapy which involves inhibitionof the PD-L1/PD-1 pathway.

Example 20 Association of PD-L1 Expression on Tumor Infiltrating ImmuneCells and Tumor Cell with Response to Anti-PD-L1 Treatemnt1

In the ongoing Phase 1 study, a clear association of response toanti-PD-L1 treatment with PD-L1 expression in both tumor infiltratingimmune cells (IC) and tumor cells was observed. As illustrated in FIG.29, the association between PD-L1 expression in tumor infiltratingimmune cells (IC) and response to anti-PD-L1 treatment was observed inpatients with NSCLC (FIG. 29(a)) as well as in all patients (FIG.29(b)). Similarly, the association between PD-L1 expression in tumorcells (TC) and response to anti-PD-L1 treatment was observed in patientswith NSCLC (FIG. 30(a)) as well as in all patients (FIG. 30(b)).

Although the foregoing invention has been described in some detail byway of illustration and example for purposes of clarity ofunderstanding, the descriptions and examples should not be construed aslimiting the scope. The disclosures of all patent and scientificliterature cited herein are expressly incorporated in their entirety byreference.

What is claimed is:
 1. A method for treating a metastatic non-small celllung cancer in an individual who is likely to have an increased clinicalbenefit from treatment with an anti-PD-L1 antibody, the methodcomprising: (a) detecting the presence of a PD-L1 protein in tumorinfiltrating immune cells in a tumor tissue sample obtained from theindividual; and (b) determining the level of PD-L1 protein in tumorinfiltrating immune cells in the tumor tissue sample, wherein the tumorinfiltrating immune cells include T lymphocytes, and wherein the tumortissue sample from the individual has a detectable expression level ofthe PD-L1 protein in tumor infiltrating immune cells covering ≥ 10% oftumor area in the tumor tissue sample, thereby indicating that theindividual is likely to have an increased clinical benefit fromtreatment with the anti-PD-L1 antibody; and (c) administering aneffective amount of an anti-PD-L1 antibody to the individual, whereinthe tumor tissue sample from the individual is obtained prior totreatment with the anti-PD-L1 antibody, and wherein the anti-PD-L1antibody is atezolizumab (MPDL3280A).
 2. The method of claim 1, furthercomprising detecting presence or level of PD-1, PD-L2, or both PD-1 andPD-L2.
 3. The method of claim 1 or 2, further comprising detectingpresence or level of one or more T-cell related markers.
 4. The methodof claim 3, wherein the one or more T-cell related markers is CD8A,IFN-g, EOMES, Granzyme-A, Granzyme-B, CXCL9, or a combination thereof.5. The method of claim 1, further comprising detecting presence or levelof CX3CL1, CD45RO, IDO1, Galectin 9, MIC-A, MIC-B, CTLA-4, or acombination thereof.
 6. The method of claim 1, wherein the tumor tissuesample further comprises tumor cells, stromal cells, or a combinationthereof.
 7. The method of claim 1, wherein the tumor tissue sample isformalin-fixed and paraffin-embedded, archival, fresh, or frozen.
 8. Themethod of claim 1, wherein the increased clinical benefit comprises arelative increase in one or more of the following: objective responserate (ORR), overall survival (OS), progression free survival (PFS),complete response (CR), partial response (PR), or a combination thereof.9. The method of claim 8, wherein the increased clinical benefitcomprises a relative increase in ORR.
 10. The method of claim 1, whereinPD-L1 protein is detected in the tumor tissue sample usingimmunohistochemistry (IHC), immunofluorescence, radioimmunoassay,immunodetection methods, or a combination thereof.
 11. The method ofclaim 1, wherein PD-L1 protein is detected using IHC.
 12. The method ofclaim 11, wherein PD-L1 protein is detected using an anti-PD-L1antibody.
 13. The method of claim 11, wherein PD-L1 protein is detectedas a weak staining intensity by IHC.
 14. The method of claim 11, whereinPD-L1 protein is detected as a moderate staining intensity by IHC. 15.The method of claim 11, wherein PD-L1 protein is detected as a strongstaining intensity by IHC.
 16. The method of claim 11, wherein stainingis membrane staining, cytoplasmic staining, or a combination thereof.17. The method of claim 1, further comprising administering an effectiveamount of a second therapeutic agent to the individual, wherein thesecond therapeutic agent is a cytotoxic agent, a chemotherapeutic agent,a growth inhibitory agent, a radiation therapy agent, anti-angiogenicagent, or a combination thereof.
 18. The method of claim 4, whereinPD-1, PD-L2, the one or more T-cell related markers, or a combinationthereof are detected in the tumor tissue sample using FACS, Westernblot, ELISA, immunoprecipitation, immunohistochemistry,immunofluorescence, radioimmunoassay, dot blotting, immunodetectionmethods, HPLC, surface plasmon resonance, optical spectroscopy, massspectrometry, qPCR, RT-qPCR, multiplex qPCR or RT-qPCR, RNA-seq,microarray analysis, SAGE, MassARRAY technique, FISH, or a combinationthereof.
 19. The method of claim 4, wherein the one or more T-cellrelated markers are detected in the tumor tissue sample by proteinexpression.
 20. The method of claim 4, wherein the one or more T-cellrelated markers are detected in the tumor tissue sample by nucleic acidexpression.
 21. The method of claim 20, wherein an increased level ofthe one or more T-cell related markers in the tumor tissue samplecompared to the level of the one or more T-cell related markers in areference sample indicates that the individual is likely to have anincreased clinical benefit from treatment with the anti-PD-L1 antibody.22. The method of claim 20, wherein the one or more T-cell relatedmarkers are detected using RT-qPCR or RNA-seq.
 23. The method of claim21, wherein the reference sample is: (a) a sample from one or moreindividuals with the cancer who is not the individual undergoingtreatment; (b) a sample from one or more healthy individuals who is notthe individual undergoing treatment; or (c) a sample from the individualundergoing treatment.
 24. The method of claim 21, wherein the referencesample is a tissue sample, a plasma sample, or a serum sample.
 25. Amethod for treating a metastatic non-small cell lung cancer in anindividual who is likely to have an increased clinical benefit fromtreatment with an anti-PD-L1 antibody, the method comprising: (a)detecting presence of a PD-L1 protein in tumor infiltrating immune cellsin a tumor tissue sample obtained from the individual; and (b)determining the level of PD-L1 protein in tumor infiltrating immunecells in the tumor tissue sample, wherein the tumor infiltrating immunecells include T lymphocytes, and wherein the tumor tissue sample fromthe individual has a detectable expression level of the PD-L1 protein intumor infiltrating immune cells covering ≥ 10% of tumor area in thetumor tissue sample, thereby indicating that the individual is likely tohave an increased clinical benefit from treatment with the anti-PD-L1antibody; and (c) administering an effective amount of an anti-PD-L1antibody to the individual, wherein the tumor tissue sample from theindividual is obtained prior to treatment with the anti-PD-L1 antibody,wherein the anti-PD-L1 antibody is atezolizumab (MPDL3280A), wherein theincreased clinical benefit comprises a relative increase in ORR, andwherein the PD-L1 protein is detected using IHC.
 26. The method of claim25, wherein the IHC is performed using the Ventana Benchmark XT orBenchmark Ultra system.